Treatment Practices of Arizona Nurse Practitioners for Older Adults with Depression

Abstract

Depression is not a normal part of aging; despite this, 15-17% of older adults have symptoms of depression (Lakkis & Mahmassani, 2015). Depression in older adults not only negatively impacts quality of life, but also negatively impacts co-morbid disease progression (Gallagher et al., 2016; Oza, Patel, & Baptist, 2016; Sinnige et al., 2013; Song et al., 2014). Depression treatment improves co-morbid disease outcomes (Bogner et al., 2016; Wood et al., 2015). Arizona has a large population of older adults and the number of older adult is projected to increase 174% by the year 2050 (Arizona Department of Health Services, n.d.). The majority of depressed patients seek treatment in the primary care setting (Lakkis & Mahmassani, 2015; Samuels et al., 2015). Arizona has over five thousand nurse practitioners working in primary care (Arizona Department of Health Services, 2014b). The purpose of this project was to determine the treatment practices of nurse practitioners caring for older adults with depression in southern Arizona. A needs assessment, using a self-administered survey, was conducted to determine how southern Arizona nurse practitioners self-identify their ability to recognize and treat older adult depression. Results revealed that southern Arizona nurse practitioners have barriers to recognition and treatment of depression in older adults. Barriers to the recognition of depression in older adults included the older adult patient’s medical complaint, limited appointment times in the primary care setting, and limited experience as a nurse practitioner. Treatment barriers identified by survey results included the older adult patient’s attitude toward depression, financial status, and ability to participate in depression treatment. The majority of these barriers are consistent with evidence established in previous studies. The ability of the older adult to participate in depression treatment was a barrier identified in the results not found in the synthesis of evidence. This project supports existing evidence regarding barriers to the recognition and treatment of older adult depression in the primary care setting. Further research is indicated to evaluate if removing the identified barriers will increase the nurse practitioners’ ability to recognize and treat depression in the older adult.