Marie-Andrée Tremblay1, Isabelle Denis2, Stéphane Turcotte3, Richard P Fleet4, Patrick Archambault5, Clermont E Dionne6, Guillaume Foldes-Busque7. 1. School of Psychology, Faculty of Social Sciences, University Laval, 2325 rue des Bibliothèques, Pavillon Félix-Antoine-Savard, room 1018, Québec G1V 0A6, Québec, Canada; Research Center of the university affiliated hospital Hôtel-Dieu de Lévis, Chaudière-Appalaches Integrated Center for Health and Social Services, 143 rue Wolfe, Pavillon des Augustines, room 4817, Lévis G6V 3Z1, Québec, Canada. Electronic address: marie-andree.tremblay.3@ulaval.ca. 2. School of Psychology, Faculty of Social Sciences, University Laval, 2325 rue des Bibliothèques, Pavillon Félix-Antoine-Savard, room 1018, Québec G1V 0A6, Québec, Canada; Research Center of the university affiliated hospital Hôtel-Dieu de Lévis, Chaudière-Appalaches Integrated Center for Health and Social Services, 143 rue Wolfe, Pavillon des Augustines, room 4817, Lévis G6V 3Z1, Québec, Canada. Electronic address: isabelle.denis@psy.ulaval.ca. 3. Research Center of the university affiliated hospital Hôtel-Dieu de Lévis, Chaudière-Appalaches Integrated Center for Health and Social Services, 143 rue Wolfe, Pavillon des Augustines, room 4817, Lévis G6V 3Z1, Québec, Canada. Electronic address: stephane_turcotte@sss.gouv.qc.ca. 4. Research Center of the university affiliated hospital Hôtel-Dieu de Lévis, Chaudière-Appalaches Integrated Center for Health and Social Services, 143 rue Wolfe, Pavillon des Augustines, room 4817, Lévis G6V 3Z1, Québec, Canada; Department of Family and Emergency Medicine, Faculty of Medicine, University Laval, 1050 avenue de la Médecine, Pavillon Ferdinand-Vandry, room 4633, Québec G1V 0A6, Québec, Canada. Electronic address: richard.fleet@fmed.ulaval.ca. 5. Research Center of the university affiliated hospital Hôtel-Dieu de Lévis, Chaudière-Appalaches Integrated Center for Health and Social Services, 143 rue Wolfe, Pavillon des Augustines, room 4817, Lévis G6V 3Z1, Québec, Canada; Department of Family and Emergency Medicine, Faculty of Medicine, University Laval, 1050 avenue de la Médecine, Pavillon Ferdinand-Vandry, room 4633, Québec G1V 0A6, Québec, Canada. 6. Research Center of the Québec University Hospital (CHU), St-Sacrement Hospital, 1050 Chemin Ste-Foy, Québec G1S 4L8, Québec, Canada. Electronic address: clermont.dionne@crchudequebec.ulaval.ca. 7. School of Psychology, Faculty of Social Sciences, University Laval, 2325 rue des Bibliothèques, Pavillon Félix-Antoine-Savard, room 1018, Québec G1V 0A6, Québec, Canada; Research Center of the university affiliated hospital Hôtel-Dieu de Lévis, Chaudière-Appalaches Integrated Center for Health and Social Services, 143 rue Wolfe, Pavillon des Augustines, room 4817, Lévis G6V 3Z1, Québec, Canada. Electronic address: guillaume.foldes-busque@psy.ulaval.ca.
Abstract
OBJECTIVES: This study aimed to estimate the incidence of medical consultations six months after an emergency department (ED) consultation for non-cardiac chest pain (NCCP). It also investigated the role of heart-focused anxiety (HFA) and other factors in predicting an increased healthcare utilization in these patients. METHOD: This was a prospective study of 428 patients who came to an ED with NCCP. Patients completed an interview and questionnaires assessing HFA, psychological distress, the characteristics of NCCP, and comorbidities. Their medical consultations were assessed by telephone interview six months later. The contribution of each factor was assessed using a binomial negative regression. RESULTS: Eighty-three percent of patients reported at least one medical consultation (mean=3.1, standard deviation=3.9). HFA (incident rate ratio 1.01; 95% CI, 1.00-1.02), the presence of a medical condition (2.14; 1.51-3.03), NCCP frequency (1.49; 1.16-1.91) and NCCP-related interference (1.08; 1.04-1.13) were predictive of further medical consultations. CONCLUSIONS: A significant proportion of patients with NCCP are at risk of multiple medical consultations following discharge from the ED. HFA appears as a determinant of medical consultations after controlling for multiple confounding factors.
OBJECTIVES: This study aimed to estimate the incidence of medical consultations six months after an emergency department (ED) consultation for non-cardiac chest pain (NCCP). It also investigated the role of heart-focused anxiety (HFA) and other factors in predicting an increased healthcare utilization in these patients. METHOD: This was a prospective study of 428 patients who came to an ED with NCCP. Patients completed an interview and questionnaires assessing HFA, psychological distress, the characteristics of NCCP, and comorbidities. Their medical consultations were assessed by telephone interview six months later. The contribution of each factor was assessed using a binomial negative regression. RESULTS: Eighty-three percent of patients reported at least one medical consultation (mean=3.1, standard deviation=3.9). HFA (incident rate ratio 1.01; 95% CI, 1.00-1.02), the presence of a medical condition (2.14; 1.51-3.03), NCCP frequency (1.49; 1.16-1.91) and NCCP-related interference (1.08; 1.04-1.13) were predictive of further medical consultations. CONCLUSIONS: A significant proportion of patients with NCCP are at risk of multiple medical consultations following discharge from the ED. HFA appears as a determinant of medical consultations after controlling for multiple confounding factors.
Authors: Joanne Castonguay; Stéphane Turcotte; Richard P Fleet; Patrick M Archambault; Clermont E Dionne; Isabelle Denis; Guillaume Foldes-Busque Journal: Biopsychosoc Med Date: 2020-06-30
Authors: Eva R Broers; Paul Lodder; Viola R M Spek; Jos W M G Widdershoven; Susanne S Pedersen; Mirela Habibović Journal: Pacing Clin Electrophysiol Date: 2019-03-05 Impact factor: 1.976