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Detecting and addressing adolescent issues and concerns

Evaluating the efficacy of a primary care previsit questionnaire

Bärbel Knäuper, DrPhil
Associate Professor in the Department of Psychology at McGill University in Montreal, Que.

Michelle Roseman
Psychology student at McGill University.

Perry Adler, MA PhD
Assistant Director of the Teenage Health Unit and Director of the Psychology Internship and Training Program at the Herzl Family Practice Centre at the Jewish General Hospital in Montreal.

Michael Malus, MD CCFP FCFP
Associate Professor in the Department of Family Medicine at McGill University and Director of the Herzl Family Practice Centre at the Jewish General Hospital

Correspondence: Dr Knäuper, McGill University, Department of Psychology, 1205 Dr Penfield Ave, Montreal, QC H3A 1B1; telephone 514 398-8186; fax 514 398-4869; e-mail barbel.knauper{at}mcgill.ca

OBJECTIVE To assess the efficacy of a previsit questionnaire (PVQ), implemented without formal training, that was designed to screen for biomedical and psychosocial health issues and concerns among adolescent patients in a hospital-based primary care clinic, and to examine the subsequent action taken for health issues and concerns identified with the PVQ.

DESIGN Retrospective review of adolescent medical charts, using a pre-post design.

SETTING An outpatient primary care clinic located in an urban teaching hospital in Montreal, Que.

PARTICIPANTS A total of 210 adolescent patients aged 13 to 19 who visited the clinic between 2000 and 2004.

MAIN OUTCOME MEASURES The type (medical vs psychosocial) and number of issues detected and actions taken by physicians in one-to-one consultations with adolescent patients 2 years before (2000–2002) and 2 years after (2002–2004) PVQ implementation, as noted in the patients’ medical charts.

RESULTS In total, 105 charts were reviewed for each group. An increase in the number of psychosocial issues was detected following the introduction of the PVQ. An increase in the frequency of action taken for psychosocial concerns and a decrease in the frequency of medical action taken by physicians were found after PVQ implementation. More notations related to psychosocial concerns were also found in the adolescents’ charts after introduction of the PVQ.

CONCLUSION A PVQ is an effective strategy to improve adolescent screening for psychosocial issues and concerns. Implementing such a questionnaire requires no training and can therefore be easily incorporated into clinical practice.