Wicher A Bokma1, Neeltje M Batelaan2, Aernout M Beek3, Annette D Boenink4, Jan H Smit5, Anton J L M van Balkom6. 1. Department of Psychiatry and the EMGO Institute for Health and Care Research, VU-University Medical Center Amsterdam and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands. Electronic address: w.bokma@ggzingeest.nl. 2. Department of Psychiatry and the EMGO Institute for Health and Care Research, VU-University Medical Center Amsterdam and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands. Electronic address: n.batelaan@ggzingeest.nl. 3. Department of Cardiology, VU-University Medical Center, De Boelelaan 1117, 1081 HZ Amsterdam, the Netherlands. Electronic address: am.beek@vumc.nl. 4. Department of Psychiatry and the EMGO Institute for Health and Care Research, VU-University Medical Center Amsterdam and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands. Electronic address: ad.boenink@vumc.nl. 5. Department of Psychiatry and the EMGO Institute for Health and Care Research, VU-University Medical Center Amsterdam and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands. Electronic address: jh.smit@ggzingeest.nl. 6. Department of Psychiatry and the EMGO Institute for Health and Care Research, VU-University Medical Center Amsterdam and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands. Electronic address: t.balkom@ggzingeest.nl.
Abstract
OBJECTIVE: This study assesses the feasibility and outcome of the implementation of a screening program for classifying panic disorder (PD) in patients presenting with noncardiac chest pain (NCCP(1)), when integrated in routine cardiac emergency department (CED(2)) care. METHODS: Barrier analyses were made during the pilot phase and implementation period. NCCP patients aged 18-70 years presenting at the CED (n=252) were eligible for screening with the Hospital Anxiety and Depression Scale (HADS). Those scoring above cutoff on the HADS were referred to the psychiatric department and received the Composite International Diagnostic Interview. RESULTS: Screening was initiated in 60 patients (23.8%), of whom nine refused participation. Staff adherence remained low despite implementing several improvements in the screening procedure. In total, 39 patients completed the program; 8 were diagnosed with a psychiatric disorder, including 2 patients with PD. CONCLUSION: Feasibility of implementation of this screening program for PD in NCCP patients in routine CED care was limited because offering screening frequently conflicted with provision of acute care and because patients showed relatively high refusal rates. Contrasting our assumption, various other psychiatric disorders besides PD were classified.
OBJECTIVE: This study assesses the feasibility and outcome of the implementation of a screening program for classifying panic disorder (PD) in patients presenting with noncardiac chest pain (NCCP(1)), when integrated in routine cardiac emergency department (CED(2)) care. METHODS: Barrier analyses were made during the pilot phase and implementation period. NCCP patients aged 18-70 years presenting at the CED (n=252) were eligible for screening with the Hospital Anxiety and Depression Scale (HADS). Those scoring above cutoff on the HADS were referred to the psychiatric department and received the Composite International Diagnostic Interview. RESULTS: Screening was initiated in 60 patients (23.8%), of whom nine refused participation. Staff adherence remained low despite implementing several improvements in the screening procedure. In total, 39 patients completed the program; 8 were diagnosed with a psychiatric disorder, including 2 patients with PD. CONCLUSION: Feasibility of implementation of this screening program for PD in NCCP patients in routine CED care was limited because offering screening frequently conflicted with provision of acute care and because patients showed relatively high refusal rates. Contrasting our assumption, various other psychiatric disorders besides PD were classified.