A Comparison of Face-to-Face Versus Tablet-Based Delivery of the Patient Health Questionnaire-2 Screening for Depression in Primary Care

Primary care practitioners have long been encouraged to screen adult patients for depression, as reflected by national guidelines from the United States Preventive Services Task Force (USPSTF) and recent federal initiatives aimed at bolstering screening rates. The Patient Health Questionnaire-2, or PHQ-2, is a simple, commonly used tool for depression screening. However, results can be skewed due to variability in the way in which questions are delivered. This study, conducted in seven West Virginia primary care centers from August 2016 to October 2017, evaluated delivery of the PHQ-2 via face-to-face administration by clinical staff compared to a scripted, video-based delivery using a tablet computer, here called the electronic PHQ-2 or ePHQ-2. This observational study finds a significant, increased difference in positive screening results when administered face-to-face by clinical staff compared to a scripted, tablet-based delivery (X2 (1, N = 655) = 5.32, p = 0.02). Given this important difference between groups, this study highlights the need for further exploration into the fidelity of PHQ-2 delivery and acceptance of such technology among patients and health care providers.