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Patient-perceived barriers to a screening program for depression: a patient opinion survey of hemodialysis patients. | LitMetric

AI Article Synopsis

  • Depression is common but often goes undiagnosed in patients with end-stage renal disease; this study highlights the barriers that prevent these patients from participating in screening and treatment for depression.
  • In a study of 160 hemodialysis patients, over 73% reported at least one barrier to participation, with those experiencing depressive symptoms being significantly more likely to identify barriers compared to those without symptoms.
  • Key barriers included concerns about medication side effects, the burden of additional medication, and beliefs that their depression was not serious enough to warrant treatment.

Article Abstract

Background: Depression is a prevalent, yet underdiagnosed, psychiatric disorder among patients with end-stage renal disease. Active case identification through routine screening is suggested; however, patient-related barriers may reduce the effectiveness of screening for, and treating, depression. This study aimed to explore the perceived barriers that limit patients from participating in screening and treatment programs for depression.

Methods: In a cross-sectional study of chronic maintenance hemodialysis patients, the Perceived Barriers to Psychological Treatment questionnaire, adapted to include screening, was used to measure perceived barriers The two-item Patient Health Questionnaire was used to identify patients with depressive symptoms.

Results: Of 160 participants, 73.1% reported at least one barrier preventing them from participation [95% confidence interval (95% CI) 66.2-80.0%]. Patients with depressive symptoms were more likely to perceive at least one barrier to a screening program for depression compared with those without depressive symptoms (96% versus 68.9%, respectively; odds ratio = 10.8; 95% CI 1.4-82.8; P = 0.005). The association of the barrier scores with depressive symptoms remained significant after adjustment for patient's characteristics. The most common barriers that patients expressed were concerns about the side effects of any antidepressant medications that may be prescribed (40%), concerns about having more medications (32%), feeling that the problem is not severe enough (23%) and perceiving no risk of depression (23%).

Conclusions: Negative perceptions about depression and its treatment among hemodialysis patients constitute an important barrier to identifying this condition and first need to be addressed before implementing a screening program in this population.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716221PMC
http://dx.doi.org/10.1093/ckj/sfx047DOI Listing

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