- Jesse Wingate, PhD, Director of Behavioral Health, Eastern Shore Rural Health System, Eastville, VA
- Scott Wolpin, DMD, Chief Dental Officer, Eastern Shore Rural Health System, Onancock, VA
Approximately one in five adults with Type II diabetes experiences depressive symptoms which affect self-management of overall health and well-being. Patients with multiple chronic conditions, such as diabetes and depression, have lower medication, dietary, and physical activity adherence thereby elevating risk for other comorbid conditions to develop. In effort to address diabetes and depression management, Eastern Shore Rural Health System, Inc. (ESRHS) participated in a four-month integrative health pilot initiative aimed at increasing depression screening and monitoring of diabetes management at dental hygiene recall visits. Dental hygiene patients with elevated HbA1c were identified using a registry report and were screened for depression in the waiting room prior to their visit. Hygienists were trained to address positive depression screens and elevated HbA1c values which involved initiation of in-house consultation with a behaviorist or health education services, respectively. Data were collected and the clinical pathway was gradually improved over the course of the four-month pilot program. The increase in screening of patients for depression and diabetes resulted in expansion of this initiative to other hygienists across ESRHS clinical sites in early 2022.
- Develop an oral health clinical pathway for effective screening of depression at dental visits.
- Create a process map that details roles and responsibilities of a multi-disciplinary team in effective chronic care management of patients.
- Identify 1-2 ways of enhancing multi-disciplinary integration in closing `care gaps' at oral health visits and improving upon quality indicator perfor