Int J Family Med Prim Care | Volume 2, Issue 2 | Research Article | Open Access

Implementing an Algorithm to Promptly Address Depression Screening Results in Hemodialysis Patients

Maryann Ugoh and Maureen Courtney

Department of Nursing, College of Nursing and Health Innovation, University of Texas, USA

*Correspondance to: Maureen Courtney 

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A major mental health issue for patients with End-Stage Renal Disease (ESRD) on dialysis is depression. More than a quarter of the patients on dialysis have dealt with depression at a particular time during the course of their treatment. Being hospitalized continuously, losing self-confidence, and sometimes not having family support pose a risk for depression among ESRD patients. Screening for depression and promptly addressing the result is a key to reducing and preventing the outcomes associated with depression. The Beck Depression Inventory -II (BDI-II) tool is a valid tool for depression screening in ESRD patients. A BDI–II cutoff score of >14 to 16 implies an increased positive predictive value for diagnosing depression among ESRD patients. In many cases, patients are not referred for depression management by the nurses at the dialysis clinics even with BDI scores above 14 and 16. This project sought to establish whether using an algorithm for the BDI scores would increase the reporting rate of depressed ESRD patients to the nephrologists for evaluation and possible treatment. A group of nurses working in a hemodialysis clinic were educated on an algorithm that addressed the scores obtained using the BDI–II tool. A pretest-posttest design was adopted, and the number of referrals made before and after the education program compared. Data obtained during the project were analyzed and showed that using the algorithm produced a 100% improvement on the reports made by the nurses. The nurses further reported prompt action taken by the nephrologist to address the depression screening result.


End-stage renal disease; Depression; Hemodialysis


Ugoh M, Courtney M. Implementing an Algorithm to Promptly Address Depression Screening Results in Hemodialysis Patients. Int J Fam Med Prim Care. 2021; 2(2): 1035..

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