UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Usefulness of PHQ-9 in primary care to determine meaningful symptoms of low mood: a qualitative study

Malpass, A; Dowrick, C; Gilbody, S; Robinson, J; Wiles, N; Duffy, L; Lewis, G; (2016) Usefulness of PHQ-9 in primary care to determine meaningful symptoms of low mood: a qualitative study. British Journal of General Practice , 66 (643) e78-e84. 10.3399/bjgp16X683473. Green open access

[thumbnail of malpass et al.pdf]
Preview
Text
malpass et al.pdf - Published Version

Download (75kB) | Preview

Abstract

BACKGROUND: Self-administered questionnaires, such as the Patient Health Questionnaire (PHQ-9), are regularly used in clinical practice to guide prescribing or to measure recovery and response to treatment. There are concerns that patients are not all interpreting the questionnaire items in the same way. Cognitive interviewing is a research technique that identifies 'interpretative measurement error' (IME). IME is distinct from traditional components of measurement error, such as not reading the question as worded, or recording answers inaccurately. AIM: To use cognitive interviewing techniques to explore patterns in answer mapping and comprehension of the PHQ-9 questionnaire to ascertain whether the measure captures meaningful symptoms of low mood. DESIGN AND SETTING: Qualitative study using cognitive interviewing techniques and card sorting in six GP practices in Bristol. METHOD: The study recruited 18 participants at the point of entry to a longitudinal primary care depression cohort study, PANDA (the indications for Prescribing ANtiDepressants that will leAd to a clinical benefit). Participants were interviewed 2, 4, and 6 weeks after their baseline visit. Cognitive interviews were digitally recorded. Analysis used the digital audio file, rather than verbatim transcripts, as it retained important features needed for analyses. RESULTS: Cognitive interviewing revealed that items on the PHQ-9 are interpreted in a range of ways, that patients often cannot 'fit' their experience into the response options, and therefore often feel the questionnaire is misrepresenting their experience of meaningful symptoms of low mood. CONCLUSION: The PHQ-9 may be missing the presence and/or intensity of certain symptoms that are meaningful to patients. Clinicians should adopt caution when using it.

Type: Article
Title: Usefulness of PHQ-9 in primary care to determine meaningful symptoms of low mood: a qualitative study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.3399/bjgp16X683473
Publisher version: http://dx.doi.org/10.3399/bjgp16X683473
Language: English
Additional information: Copyright © British Journal of General Practice 2016.
Keywords: PHQ-9, cognitive interviewing, depression, mood questionnaire, prescribing in primary care, safety culture
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/1476713
Downloads since deposit
236Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item