Screening and Treatment of Depression in Parkinson’s Disease Within Movement Disorders Centers (P7-11.015)

Implement depression screening using a validated instrument for people with Parkinson’s (PWP) as part of standard of care in the specialist movement disorders setting and evaluate feasibility.

The Parkinson’s Foundation’s (PF) Parkinson’s Outcomes Project study found that a substantial proportion of PWP treated at select PF Centers of Excellence (COE) have depressed mood and don’t receive mental health services. Variability in depression screening suggests an opportunity to improve clinical care.

At five PF COEs depression screening, diagnosis and treatment practices were evaluated through retrospective medical record reviews at each site. The 15-item Geriatric Depression Scale (GDS-15) was used to systematically screen for depression. A depression factsheet, a treatment algorithm, and a depression-specific shared decision-making tool were shared with sites. Qualitative interviews with select clinicians and study participants from each site were conducted to understand the site’s standard practice and experience implementing the GDS-15. PWP’s who screened positive for depression (GDS-15 >4) were invited to be followed for 12 months to collect quality-of-life measures and details of depression treatment.

Over the year prior to depression screening implementation, site screening rates for depression ranged from 56–92%, but on average only 14% (range 0–57%) of screening across the 5 sites used a validated screening instrument. During the implementation phase formal screening rates, all done with the GDS-15, averaged 68% (range 54–84%) across the 5 sites. 378/1036 PWP screened positive. Among 137 screen positive patients followed prospectively, 15 initiated new depression treatment, while 72 participants maintained ongoing treatment. Data collection for follow-up visits are ongoing.

Implementation of systematic screening using the GDS-15 is feasible although difficult to achieve at high rates. Ongoing follow up will examine changes in quality of life and symptoms of depression.

Disclosure: Dr. Beck has received personal compensation for serving as an employee of Parkinson. Mr. Meyer has received personal compensation for serving as an employee of Parkinson’s Foundation. Anna Naito has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Parkinson’s Foundation. Dr. Marras has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine Biosciences. The institution of Dr. Marras has received research support from Theravance Inc. The institution of Dr. Marras has received research support from Centogene. Daniel Weintraub has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Clintrex. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scion. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Signant. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunovion. Daniel Weintraub has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Movement Disorder Society. The institution of Daniel Weintraub has received research support from NIH. The institution of Daniel Weintraub has received research support from Fox Foundation. The institution of Daniel Weintraub has received research support from IPMDS. Daniel Weintraub has received intellectual property interests from a discovery or technology relating to health care. Dr. Dahodwala has received personal compensation in the range of $0-$499 for serving as a Consultant for Genetech. Dr. Dahodwala has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. The institution of Dr. Dahodwala has received research support from AbbVie. The institution of Dr. Dahodwala has received research support from Medtronic. Dr. Spindler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. The institution of Dr. Spindler has received research support from Abbvie. The institution of Dr. Spindler has received research support from Supernus. The institution of Dr. Spindler has received research support from Abbott. The institution of Dr. Spindler has received research support from Takeda. The institution of Dr. Spindler has received research support from Praxis. The institution of Dr. Spindler has received research support from UCB. Dr. Spindler has received publishing royalties from a publication relating to health care. Dr. Davis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Davis has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Parkinson Foundation. Dr. Brown has nothing to disclose. Dr. Miyasaki has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for American Academy of Neurology. Dr. Miyasaki has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Oxford University Press. The institution of Dr. Miyasaki has received research support from PCORI. The institution of Dr. Miyasaki has received research support from Brain Canada. The institution of Dr. Miyasaki has received research support from Canadian Consortium on Neurodegeneration in Aging. The institution of Dr. Miyasaki has received research support from University Hospital Foundation. The institution of Dr. Miyasaki has received research support from Social Science and Health Research Council. Dr. Mills has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Tilosia. The institution of Dr. Mills has received research support from NINDS. The institution of Dr. Mills has received research support from MJFF. The institution of Dr. Mills has received research support from GKC. Eugene Nelson has nothing to disclose. Dr. Neault has a non-compensated relationship as a Research Patient Advocate with Parkinson’s Foundation that is relevant to AAN interests or activities. Dr. Mantri has received personal compensation in the range of $0-$499 for serving as a Consultant for Deep Brain Innovations, LLC. Dr. Mantri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Grey Matter Technology. The institution of Dr. Mantri has received research support from The Michael J Fox Foundation for Parkinson Research. Mrs. Allen has received research support from Parkinson’s Foundation. Mrs. Allen has received personal compensation in the range of $500-$4,999 for serving as a COE Site Reviewer with Parkinson’s Foundation. Mrs. Allen has received personal compensation in the range of $500-$4,999 for serving as a Speaker with World Parkinson’s Coalition.