Date of Scholarly Project Submission

8-2018

Degree Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Faculty Chairperson

Kristi Robinia

Second Committee Member

Katherine Menard

Third Committee Member

Michelle Johnson

Abstract

The rate of depression across the United States is on the rise with over 16.2 million people experiencing a depressive episode per year (Siu & and the US Preventive Services Task Force [USPSTF], 2016). Medications to treat depression typically take weeks or months to see clinical improvement (Uphold & Graham, 2013). If the medication is not effective, a dose or medication change may occur, lengthening the time spent in a depressive state. This scholarly project retrospectively analyzed charts at a rural primary care practice that implemented GeneSight® psychotropic pharmacogenomic testing for treatment resistant depression. This project sought to understand if PHQ-9 depression scores were impacted by pharmacogenetic testing. Comparison of PHQ-9 scores across the two measurement periods during the study period was completed by using a paired t-test. The mean PHQ-9 scores decreased from 7 to 3.5 which did not reach a level of statistical significance. A comparison of the total number of visits for depression in the control and test group patients was completed by using independent samples t-test which showed no significant difference in mean number of visits. A major limitation of this study was the small sample size which impacted the statistical analysis. The review of literature and project findings support the need for further research on the implementation of pharmacogenomic testing to treat refractory depression in a family practice setting.

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