Esketamine Provider Education at an Outpatient Psychiatry Clinic

Abstract

Purpose: The purpose of this quality improvement project was to increase the knowledge base of providers on the benefits, indications, safety, and monitoring protocols of esketamine and evaluate their confidence and intention to use esketamine in practice.Background: Major Depressive Disorder is one of the most common and devastating mental health illnesses that negatively affects people worldwide. It is associated with higher societal costs and more significant functional impairment than many other chronic diseases. However, treating depression is significantly challenging, with some patients nonresponsive to therapeutic interventions. These patients are diagnosed as having treatment-resistant depression. Method: This quality improvement project was designed using the Model for Improvement and PDSA cycle. Participants were recruited via email to view a web-based educational in-service that educated them on esketamine for treatment-resistant depression. Participants completed a pretest and posttest survey to measure change in the areas of knowledge, perceived benefit, confidence in utilizing this treatment modality in the future, barriers to utilization, and evaluation of the educational material presented. Results: A pretest/posttest format was utilized with a web-based educational in-service regarding esketamine. Median scores were increased in the first five statements concerning participants’ perceived knowledge about benefits, indications, safety, monitoring protocols, and confidence in the use of esketamine. The final statement, which assessed the participants’ intent to become certified in the use of esketamine for TRD, showed no change in the median score. Additional information was obtained about perceived barriers to becoming certified. These included demographics of the provider’s patient population, staffing concerns, cost, and monitoring requirements. Conclusion: The implementation of the education was successful, as the anticipated outcomes were achieved. Results show an increase in provider knowledge of indications, perceived benefit, monitoring protocol, and intent to implement esketamine into practice.