Incidental findings: A practical protocol for reporting elevated depressive symptoms in behavioral health research.
McKenzie K Wallace, Alexandra B Jeanblanc, Carol M Musil
PMID 32513473WHAT IT FOUND
An RN phone call reached 87 of 94 grandmother caregivers with CES-D scores over 30, told them their score was elevated, and offered resources.
Eight did not know they had depressive symptoms. No long-term outcomes were measured.
Key findings
01Among 348 participants, 94 had a CES-D score over 30, and 87 were contacted.
02The protocol used an RN phone call for scores over 30, explained the elevated depression score, asked about current care, and offered primary care or 211 resources.
03Of the 87 contacted, 8 did not know they had elevated depressive symptoms, and one-third were seeing a therapist and one-third were taking medication.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The paper reports implementation of a reporting protocol, not a test of whether the calls improved care, symptoms, or long-term outcomes. The study took place in an online research trial with grandmother caregivers, so it may not fit clinical settings or other populations. The protocol relied on a registered nurse and a psychiatric advanced practice registered nurse, and the authors say teams without licensed healthcare professionals may not be able to replicate it. The authors do not know the longitudinal outcomes of care; they only heard anecdotally that some participants later spoke with a provider. The paper does not report randomization details, blinding, dropout, or results of the stress interventions. The second-call threshold was chosen by the authors, and the paper states there was no available evidence for when to make a second call.
Declared interests
The authors declare no conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not read this as proof that reporting elevated CES-D scores improves depression care. The paper describes a nurse phone protocol and how many participants were reached, but it does not test long-term outcomes, provider visits, or symptom improvement.