Assessing the quality of care for paediatric depression and anxiety in Australia: A population-based sample survey

Louise A. Ellis, Louise Wiles, Ruth Selig, Kate Churruca, Raghu Lingam, Janet C. Long, Charlotte J. Molloy, Gaston Arnolda, Hsuen P. Ting, Peter Hibbert, S. Bruce Dowton, Jeffrey Braithwaite

Research output: Contribution to journalArticle

Abstract

Objective: We examine the prevalence of quality care (as measured by adherence to recommendations in clinical practice guidelines) for Australian paediatric patients (⩽15 years) with depression and/or anxiety, using data from the CareTrack Kids study; a population-based study of the quality of healthcare practice in inpatient and ambulatory healthcare settings. Methods: A multistage stratified sample identified records of 6689 children. Of these, 156 records were identified for depression and 356 for anxiety. These were assessed for adherence to 15 depression and 13 anxiety indicators, respectively, using a review of medical records. Results: Adherence to assessment and management guidelines was low for both conditions: assessment bundle (depression = 33%, 95% confidence interval = [20, 48]; anxiety = 54%, 95% confidence interval = [43, 64] and depression management bundle = 35%, 95% confidence interval = [15, 60]). Across both conditions, the highest adherence was recorded for indicators that addressed prescription of medications (e.g. venlafaxine, 100%; benzodiazepines, 100%; selective serotonin reuptake inhibitor, 94% and antidepressants, 91%), while compliance was the lowest for ensuring children with depression had an emergency safety plan (44%), informing parents of the risks and benefits of prescribed anxiety medication (51%) and assessment for other causes (59% for depression; 68% for anxiety). Conclusion: These findings suggest that strategies are needed to improve guideline adherence for mental health disorders in children and adolescents, particularly among general practitioners. Learning from these indicators could inform clinical prompts in electronic medical records, as well as links to additional information, to assist in decision-making and streamline work practices.

LanguageEnglish
Pages1013-1025
Number of pages13
JournalAustralian and New Zealand Journal of Psychiatry
Volume53
Issue number10
DOIs
Publication statusPublished - 1 Oct 2019

Keywords

  • Anxiety
  • child health
  • depression
  • guideline adherence
  • healthcare quality indicators
  • paediatrics

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Ellis, Louise A. ; Wiles, Louise ; Selig, Ruth ; Churruca, Kate ; Lingam, Raghu ; Long, Janet C. ; Molloy, Charlotte J. ; Arnolda, Gaston ; Ting, Hsuen P. ; Hibbert, Peter ; Dowton, S. Bruce ; Braithwaite, Jeffrey. / Assessing the quality of care for paediatric depression and anxiety in Australia : A population-based sample survey. In: Australian and New Zealand Journal of Psychiatry. 2019 ; Vol. 53, No. 10. pp. 1013-1025.
@article{c051468a364440fe99fd0561b8775903,
title = "Assessing the quality of care for paediatric depression and anxiety in Australia: A population-based sample survey",
abstract = "Objective: We examine the prevalence of quality care (as measured by adherence to recommendations in clinical practice guidelines) for Australian paediatric patients (⩽15 years) with depression and/or anxiety, using data from the CareTrack Kids study; a population-based study of the quality of healthcare practice in inpatient and ambulatory healthcare settings. Methods: A multistage stratified sample identified records of 6689 children. Of these, 156 records were identified for depression and 356 for anxiety. These were assessed for adherence to 15 depression and 13 anxiety indicators, respectively, using a review of medical records. Results: Adherence to assessment and management guidelines was low for both conditions: assessment bundle (depression = 33{\%}, 95{\%} confidence interval = [20, 48]; anxiety = 54{\%}, 95{\%} confidence interval = [43, 64] and depression management bundle = 35{\%}, 95{\%} confidence interval = [15, 60]). Across both conditions, the highest adherence was recorded for indicators that addressed prescription of medications (e.g. venlafaxine, 100{\%}; benzodiazepines, 100{\%}; selective serotonin reuptake inhibitor, 94{\%} and antidepressants, 91{\%}), while compliance was the lowest for ensuring children with depression had an emergency safety plan (44{\%}), informing parents of the risks and benefits of prescribed anxiety medication (51{\%}) and assessment for other causes (59{\%} for depression; 68{\%} for anxiety). Conclusion: These findings suggest that strategies are needed to improve guideline adherence for mental health disorders in children and adolescents, particularly among general practitioners. Learning from these indicators could inform clinical prompts in electronic medical records, as well as links to additional information, to assist in decision-making and streamline work practices.",
keywords = "Anxiety, child health, depression, guideline adherence, healthcare quality indicators, paediatrics",
author = "Ellis, {Louise A.} and Louise Wiles and Ruth Selig and Kate Churruca and Raghu Lingam and Long, {Janet C.} and Molloy, {Charlotte J.} and Gaston Arnolda and Ting, {Hsuen P.} and Peter Hibbert and Dowton, {S. Bruce} and Jeffrey Braithwaite",
year = "2019",
month = "10",
day = "1",
doi = "10.1177/0004867419866512",
language = "English",
volume = "53",
pages = "1013--1025",
journal = "Australian and New Zealand Journal of Psychiatry",
issn = "0004-8674",
publisher = "Informa Healthcare",
number = "10",

}

Ellis, LA, Wiles, L, Selig, R, Churruca, K, Lingam, R, Long, JC, Molloy, CJ, Arnolda, G, Ting, HP, Hibbert, P, Dowton, SB & Braithwaite, J 2019, 'Assessing the quality of care for paediatric depression and anxiety in Australia: A population-based sample survey', Australian and New Zealand Journal of Psychiatry, vol. 53, no. 10, pp. 1013-1025. https://doi.org/10.1177/0004867419866512

Assessing the quality of care for paediatric depression and anxiety in Australia : A population-based sample survey. / Ellis, Louise A.; Wiles, Louise; Selig, Ruth; Churruca, Kate; Lingam, Raghu; Long, Janet C.; Molloy, Charlotte J.; Arnolda, Gaston; Ting, Hsuen P.; Hibbert, Peter; Dowton, S. Bruce; Braithwaite, Jeffrey.

In: Australian and New Zealand Journal of Psychiatry, Vol. 53, No. 10, 01.10.2019, p. 1013-1025.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Assessing the quality of care for paediatric depression and anxiety in Australia

T2 - Australian and New Zealand Journal of Psychiatry

AU - Ellis, Louise A.

AU - Wiles, Louise

AU - Selig, Ruth

AU - Churruca, Kate

AU - Lingam, Raghu

AU - Long, Janet C.

AU - Molloy, Charlotte J.

AU - Arnolda, Gaston

AU - Ting, Hsuen P.

AU - Hibbert, Peter

AU - Dowton, S. Bruce

AU - Braithwaite, Jeffrey

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Objective: We examine the prevalence of quality care (as measured by adherence to recommendations in clinical practice guidelines) for Australian paediatric patients (⩽15 years) with depression and/or anxiety, using data from the CareTrack Kids study; a population-based study of the quality of healthcare practice in inpatient and ambulatory healthcare settings. Methods: A multistage stratified sample identified records of 6689 children. Of these, 156 records were identified for depression and 356 for anxiety. These were assessed for adherence to 15 depression and 13 anxiety indicators, respectively, using a review of medical records. Results: Adherence to assessment and management guidelines was low for both conditions: assessment bundle (depression = 33%, 95% confidence interval = [20, 48]; anxiety = 54%, 95% confidence interval = [43, 64] and depression management bundle = 35%, 95% confidence interval = [15, 60]). Across both conditions, the highest adherence was recorded for indicators that addressed prescription of medications (e.g. venlafaxine, 100%; benzodiazepines, 100%; selective serotonin reuptake inhibitor, 94% and antidepressants, 91%), while compliance was the lowest for ensuring children with depression had an emergency safety plan (44%), informing parents of the risks and benefits of prescribed anxiety medication (51%) and assessment for other causes (59% for depression; 68% for anxiety). Conclusion: These findings suggest that strategies are needed to improve guideline adherence for mental health disorders in children and adolescents, particularly among general practitioners. Learning from these indicators could inform clinical prompts in electronic medical records, as well as links to additional information, to assist in decision-making and streamline work practices.

AB - Objective: We examine the prevalence of quality care (as measured by adherence to recommendations in clinical practice guidelines) for Australian paediatric patients (⩽15 years) with depression and/or anxiety, using data from the CareTrack Kids study; a population-based study of the quality of healthcare practice in inpatient and ambulatory healthcare settings. Methods: A multistage stratified sample identified records of 6689 children. Of these, 156 records were identified for depression and 356 for anxiety. These were assessed for adherence to 15 depression and 13 anxiety indicators, respectively, using a review of medical records. Results: Adherence to assessment and management guidelines was low for both conditions: assessment bundle (depression = 33%, 95% confidence interval = [20, 48]; anxiety = 54%, 95% confidence interval = [43, 64] and depression management bundle = 35%, 95% confidence interval = [15, 60]). Across both conditions, the highest adherence was recorded for indicators that addressed prescription of medications (e.g. venlafaxine, 100%; benzodiazepines, 100%; selective serotonin reuptake inhibitor, 94% and antidepressants, 91%), while compliance was the lowest for ensuring children with depression had an emergency safety plan (44%), informing parents of the risks and benefits of prescribed anxiety medication (51%) and assessment for other causes (59% for depression; 68% for anxiety). Conclusion: These findings suggest that strategies are needed to improve guideline adherence for mental health disorders in children and adolescents, particularly among general practitioners. Learning from these indicators could inform clinical prompts in electronic medical records, as well as links to additional information, to assist in decision-making and streamline work practices.

KW - Anxiety

KW - child health

KW - depression

KW - guideline adherence

KW - healthcare quality indicators

KW - paediatrics

UR - http://www.scopus.com/inward/record.url?scp=85071074652&partnerID=8YFLogxK

U2 - 10.1177/0004867419866512

DO - 10.1177/0004867419866512

M3 - Article

VL - 53

SP - 1013

EP - 1025

JO - Australian and New Zealand Journal of Psychiatry

JF - Australian and New Zealand Journal of Psychiatry

SN - 0004-8674

IS - 10

ER -