158 Depression screening and assessment in palliative care: a multi-site regional audit

<h3>Background or Introduction</h3> In June 2023 the NICE quality standard for Depression in adults was reviewed leading to new priority statements and updated guidance.¹ Depression is common in the palliative setting and is associated with emotional distress, an increase in symptoms of pain and fatigue and a poorer prognosis.^{2 3} The aim of this audit was to establish current practice in assessment of depression and initial management in the palliative care population across the Mid-Yorkshire area. <h3>Method</h3> This multi-site project collected data from Mid-Yorkshire Hospitals and Community Palliative Care Team, Wakefield Hospice and Prince of Wales Hospice. The first 20 patients in 2024 referred to each team for an initial assessment were anonymised and reviewed. Data was collected on patient’s past medical history of depression, and symptoms of depression in line with NICE guidance.¹ For those where depression was documented, data was collected on the course, duration, severity, functional impact and management. <h3>Results</h3> Of the 80 patients audited, 66 patients (82.5%) were screened for at least one depressive symptom. The most common was loss of appetite (n=63), followed by low mood (n=31) and insomnia (n=30). 16 patients (20%) were asked about one symptom only. 17 patients (21.3%) had a pre-existing past medical history of depression. Of the 66 patients screened for depressive symptoms, 19 (28.8%) were explored in more detail, according to duration, severity, course and functional impact. 21 (31.8%) were referred to wellbeing or psychology services. 1 patient was started on an antidepressant. <h3>Conclusions</h3> Overall, depression is poorly screened for on initial assessments of patients referred for Palliative Care services. Around one third of patients had further exploration of identified symptoms or were referred to psychological services. There is opportunity to improve exploration of symptoms and management of patients referred to Palliative Care services in the Mid-Yorkshire area. <h3>References</h3> National Institute for Health and Care Excellence (2023) Depression in Adults (Quality Standard 8). Available at: www.nice.org.uk/guidance/qs8. (Accessed 17/10/2024) Hotopf M, Chidgey J, Addington-Hall J, Ly KL. Depression in advanced disease: a systematic review Part 1. Prevalence and case finding. <i>Palliat Med</i> 2002;<b>16</b>:81–97. Rayner L, Higginson IJ, Price A, Hotopf M. The Management of Depression in Palliative Care: European Clinical Guidelines. London: Department of Palliative Care, Policy &amp; Rehabilitation (www.kcl.ac.uk/schools/medicine/depts/palliative )/European Palliative Care Research Collaborative (www.epcrc.org); 2010