Detecting and addressing adolescent issues and concerns: Evaluating the efficacy of a primary care previsit questionnaire

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.