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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Brandi Pravecek

Second Advisor

Thomas Stenvig


Introduction: Depression reassessments to monitor treatment adherence and symptom severity are underutilized in primary care. Identification of depression with symptom monitoring tools and structured medical management have been shown to reduce depression symptoms, increase depression remission and follow-up rates, and improve quality outcomes.
Evidence Summary: A literature review was performed using five professional databases. Five articles reviewed measurement-based care (MBC) and two others discussed stepped algorithm treatment for effective depression management associated with patient outcomes such as depression remission, decreased depression severity, increased medication adherence, and quality improvement of the organization. Five articles focused on different technology-based interventions to improve depression symptoms. The Patient Health Questionnaire (PHQ-9) demonstrated acceptable validity and sensitivity in prior studies to measure changes in symptom severity.
Gaps: Gaps in the literature include a lack of published literature focusing on depression reassessment in rural health and a lack of specific guidelines to follow for depression management.
Recommendations for Practice: The integration of MBC or stepped guidelines for providers can improve depressed patients’ health outcomes and remission longevity.

Library of Congress Subject Headings

Depression, Mental -- Treatment.
Rural health clinics.

Number of Pages



South Dakota State University


© 2022 Rebecca Taffe