Feasibility and Effectiveness of the Implementation of Anxiety Screening for Adolescents in a Primary Care Setting

TL;DR

This study shows that routine anxiety screening for adolescents in primary care is feasible and leads to more anxiety diagnoses and treatment.

Contribution

The study demonstrates the feasibility and clinical impact of early implementation of anxiety screening in pediatric primary care.

Findings

Approximately 80% of patients were screened in the first year, with 17% having positive anxiety screens.

Anxiety diagnoses increased from 9.6% to 13.3% after implementing screening (p<0.0001).

Half of newly diagnosed patients were prescribed an intervention following a positive screen.

Abstract

The United States Preventive Services Task Force recommended routine anxiety screening for children and adolescents in 2022. This study describes the feasibility of routine anxiety screening in a primary care practice. It further examines the effects of routine anxiety screening on anxiety diagnoses and provider behavior in a setting in which anxiety screening was implemented five years in advance of the national guidelines. During the first year of implementation, approximately 80% of patients were screened, and 17% of screens were positive. A retrospective chart review of patients with positive screens found that the majority of positive screens led to a new diagnosis of anxiety and that half of newly diagnosed patients were prescribed an intervention. Screening was associated with an increase in diagnoses of anxiety disorders in the studied population from 9.6% to 13.3% (p<0.0001). Following the initial implementation, screening rates continued to rise, with an eventual plateau of >90%. Anxiety screening in the pediatric primary care setting is feasible and sustainable and led to increased provider recognition of anxiety and meaningful clinical action.

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