Perspectives on Implementing the Patient Health Questionnaire-4 in Low-Vision Service Organisations to Screen for Depression and Anxiety

Summary

The purpose of the study is to describe the process of implementing a screening questionnaire for depression and anxiety, the Patient Health Questionnaire-4 (PHQ-4), in low-vision service (LVS) organizations. The study consisted of three parts: (1) a usability study combined semi-structured interviews, in which clients (n=10) of LVS organisations express their preference for using the PHQ-4; (2) a feasibility study, in which the PHQ-4 was implemented on a small scale and its used was evaluated by health care providers (n=6) and clients (n=9); and (3) semi-structured interviews to identify barriers and facilitators for implementing the PHQ-4. Six themes were derived from the sub studies: (1) quality of the intervention, (2) applicability for clients of LVS organizations, (3) attitude and needs of clients, (4) attitude of health care providers, (5) support within LVS organizations, and (6) embedment in current practice. Results could be linked to 12 CFIR constructs. The constructs “relative advantage,” “patient needs and resources,” and “available resources” emerged most prominently in our themes as either barrier or facilitator. The PHQ-4 seems an appropriate screening instrument for use in LVS organizations because of its quality and adaptable use. It might provide opportunities to timely detect depression and anxiety, but challenges in implementing the PHQ-4 should be considered.