Document Type
DNP Project
Department
School of Nursing
Date of Degree
Spring 2025
Degree
Doctor of Nursing Practice (DNP)
Primary Advisor
Cara Padovano, DNP, APRN
Keywords
Generalized Anxiety Disorder 7; Primary care clinic; Screening tools
Abstract
Background: Generalized Anxiety Disorder (GAD) is a prevalent yet often underdiagnosed mental health issue in primary care settings. The Generalized Anxiety Disorder 7-Item (GAD-7) is a valid and reliable screening tool used for detecting GAD. However, the lack of routine screening practices in primary care contributes to the under-detection of this disorder.
Objectives: This project aimed to implement the GAD-7 screening tool in the primary care clinic to improve the early detection and diagnosis of GAD in adult patients aged 18-64. Objectives included assessing the change in GAD diagnoses and evaluating the percentage increase post- implementation.
Methods: An eight-week retrospective chart review was conducted to gather baseline data on the number of GAD diagnoses made during the pre-intervention phase. The providers and nurses were educated, and the GAD-7 tool was implemented as a routine practice during the eight-week intervention phase. The number of new GAD diagnoses (cut-off score ≥8) was determined, and the change and percentage increase in diagnoses were analyzed using a pretest-posttest design.
Results: Out of 1,001 patients, 5 (0.5%) were newly diagnosed with GAD before the intervention. In the post-intervention phase, of the 263 eligible screenings, 11 patients (4%) received new GAD diagnoses, resulting in a 3.5% increase in the diagnosis rate. Chi-square analysis revealed a statistically significant difference (χ2 = 22.605, df = 1, p < 0.001). The GAD-7 scores ranged from 0 to 18, with 89% (N=233) scoring 7 and 11% (N=30) scoring ≥8 on the GAD-7 tool. Among those 30 patients, 11 received a clinical diagnosis of GAD, and 19 were diagnosed with other anxiety disorders.
Conclusions: The increase in GAD diagnoses following screening demonstrated improvement in early detection. These findings supported the routine use of the GAD-7 tool in clinics to enhance early detection and diagnosis of GAD, ultimately enhancing patient health outcomes.
Copyright Notice
©2025 Jemika Shrestha Kastee. All rights reserved.
Recommended Citation
Kastee, J. S. (2025). Implementation of the Generalized Anxiety Disorder 7-Item (GAD-7) Screening Tool in a Primary Care Clinic. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/189
Open Access
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