WINSTON-SALEM, N.C. – May 21, 2025 – A new study from researchers at Wake Forest University School of Medicine shows an improvement in screening rates for anxiety and depression among epilepsy patients with the implementation of an electronic health record (EHR)-based strategy.
The findings appear online in the Journal of Clinical and Translational Science .
"Anxiety and depression are common in epilepsy, yet they are often under-recognized and undertreated," said Heidi Munger Clary, M.D., M.P.H. , associate professor of neurology. "But by leveraging existing clinical staff and EHR features, we can significantly increase screening rates, allowing for better patient management and treatment."
According to Munger Clary, patients with epilepsy have two to five times higher risk of anxiety or depression, so screening interventions are recommended to improve patient care.
The study was conducted at Atrium Health Wake Forest Baptist's Comprehensive Epilepsy Center. Support staff implemented anxiety and depression screening tools during patient check-in with results directly integrated into the clinic's EHR system.
The research team found that the simple EHR-based strategy increased the screening rates for anxiety and depression from 12.6% to 29.2% of clinic visits.
Munger Clary said younger patients (average age 39.3) were more likely to complete the screeners compared to older patients (average age 43.4). Additionally, white patients were more likely to complete the screeners than patients from other racial or ethnic groups.
"Our study shows that this strategy not only enhances the detection of mental health issues but also provides a feasible approach for epilepsy centers to meet quality measures for patient care, as this strategy required only three to four clicks by support staff" Munger Clary said. "However, we must continue to address the variability in screening rates among different patient demographics."
Munger Clary said that future efforts should focus on overcoming time-related obstacles and disruptions in clinic workflow during the screening process to ensure fair access to screenings for all patients. Promising strategies include using shorter screening tools and encouraging patients to complete screenings before their visits.
This work was supported by the National Institutes of Health grants KL2TR001421, UL1TR001420 and R25NS088248. Early development of some EHR-based tools adapted for this study was supported by the Agency for Healthcare Research and Quality under award number R01HS24057.
