Analysis of the UNTHSC Teen Clinic

Background: The UNTHSC Teen Clinic was established in June 2015 by Dr. Priya Bui as a result of her experiences working with teens in the UNTHSC pediatric clinic. The clinic is run ½ day per week by Dr. Bui and PA Lauren Dobbs. Typical visits include taking a thorough history and physical, screening for psychiatric problems, running special labs (for STIs, lipids, etc.) when indicated, and conducting an in-depth confidential interview to explore the teen’s environment and any risky or dangerous behavior or thoughts. The aim of this project is to analyze the first year of teen clinic so as to show others who may be interested in starting a clinic of this kind what exactly it may entail. Specifically, the research objectives were to create a raw database of information from the first year of UNTHSC’s Teen Clinic (stripped of identifiers); discover the population served; and analyze the depression and risky sexual behavior populations and the interventions used for them. Methods: Retrospective data collection and analysis. Created a raw database of all cases seen in teen clinic from 06/04/15 to 06/24/16. Collected and placed the following coded information into a protected Excel file: Age, Sex/gender, Referral Source, Chief Complaint (CC), History of Present Illness (HPI), Assessment, Medical Intervention, Psychiatric Intervention, Outcomes, Provider, and any Miscellaneous Information. Total of 196 encounters and 116 patients were included in the present study with no exclusion criteria. Analyzed chief complaint (CC), history of present illness (HPI), and assessment. Separately analyzed CC, HPI, assessments, and interventions of the Depression/Adjustment Disorder and Hypersexual Behavior populations. Preliminary Results: The top four CC, HPI, and assessments seen were determined. CC: Well child check (80), follow up (44), establish teen clinic (27), and depression (17); HPI: depressive symptoms (56), family instability (45), acute symptoms (31), well child check (29); Assessment: well child check within normal limits (72), depression (49), asthma/allergies (22), obesity (21). Populations with depression/adjustment disorder and hypersexual behavior were analyzed. In the small hypersexual group, there was successful intervention in 44% of females seen (i.e. Nexplanon placement). We found that in the depressive group 54.8% followed up. Conclusions: In its first year alone, Teen Clinic addressed a variety of unique issues not often explored in a typical pediatrician’s visit- most importantly (indicated by the frequency seen) symptoms of depression and adjustment disorder. Additionally, many teens were recommended for follow up, and many actually came back, successfully establishing a medical home. There are many possibilities for future studies, including, but not limited to: correlational analysis between family issues and risk taking behavior; analysis of patient compliance (by tracking follow up visits); analysis of outcomes from various interventions; and continuing the analysis of interventions in the hypersexual and depressed groups.