Brief report| Volume 94, ISSUE 4, P788-790, April 2013

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Electronic Screening and Decision Support for Poststroke Depression: An Exploration of Doctors' and Patients' Perceptions of Acceptability

Published:September 27, 2012DOI:



      To explore clinicians' and patients' perceptions of acceptability of an electronic screening and decision support system for poststroke depression.


      A mixed-methods study involved participants from 2 convenience samples.


      Outpatient stroke and rehabilitation clinics.


      Stroke patients (n=62) completed surveys. Seven clinicians working at clinics targeted by the depression screening process were interviewed using semi-structured interviews.


      Not applicable.

      Main Outcome Measures

      Patient data were analyzed from an acceptability survey. Qualitative data analysis involved an inductive thematic approach with constant comparison.


      Most patients found screening easy to complete and understand, important, and a good way of conveying information to the clinician. Most clinicians did not systematically discuss mood disturbances, with attenuating factors and barriers to identification both influencing identification. Variations in the management of mood centered on the use of pharmacotherapy and role overlap with general practitioners. The screening process assisted with identification and saved time during diagnosis and management.


      The positive perceptions of patients and clinicians identified in this study support the concept of routine screening and feedback for poststroke depression. This process has the potential to improve poststroke depression practice to meet national guidelines; however, evaluation of impact on patient outcome is required.


      List of abbreviations:

      PHQ-9 (Patient Health Questionnaire-9), PSD (poststroke depression)
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        • Herrmann N.
        • Seitz D.
        • Fischer H.
        • et al.
        Detection and treatment of post stroke depression: results from the registry of the Canadian Stroke Network.
        Int J Geriatr Psychiatry. 2011; 26: 1195-1200
      1. National Stroke Foundation. Clinical guidelines for stroke management. 2010. Available at: Accessed March 10, 2011.

        • Intercollegiate Stroke Working Party
        National clinical guidelines for stroke.
        3rd ed. Royal College of Physicians, London2008
        • Hart S.
        • Morris R.
        Screening for depression after stroke: an exploration of professionals' compliance with guidelines.
        Clin Rehabil. 2008; 22: 60-70
        • Kawamoto K.
        • Houlihan C.A.
        • Balas E.A.
        • Lobach D.F.
        Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success.
        BMJ. 2005; 330: 765
        • Turner A.
        • White J.
        • Hambridge J.
        • et al.
        Impact of routine electronic screening and feedback on depression symptoms in stroke: a pilot randomised controlled trial.
        Int J Stroke. 2011; 6: 27
        • Williams L.S.
        • Brizendine E.J.
        • Plue L.
        • et al.
        Performance of the PHQ-9 as a screening tool for depression after stroke.
        Stroke. 2005; 36: 635-638
      2. Holland JC, Andersen B, Breitbart WS, et al. NCCN clinical practice guidelines in oncology: distress management. Version 1. 2011. Available at: Accessed July 4, 2011.

        • Pandit N.
        The creation of theory: a recent application of the grounded theory method.
        Qual Rep. 1996; 2: 1-13