{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["22(1)"],"submitter":["Sung SC"],"pubmed_abstract":["<h4>Background</h4>Approximately 40% of Emergency Department (ED) patients with chest pain meet diagnostic criteria for panic-related anxiety, but only 1-2% are correctly diagnosed and appropriately managed in the ED. A stepped-care model, which focuses on providing evidence-based interventions in a resource-efficient manner, is the state-of-the art for treating panic disorder patients in medical settings such as primary care. Stepped-care has yet to be tested in the ED setting, which is the first point of contact with the healthcare system for most patients with panic symptoms.<h4>Methods</h4>This multi-site randomized controlled trial (RCT) aims to evaluate the clinical, patient-centred, and economic effectiveness of a stepped-care intervention in a sample of 212 patients with panic-related anxiety presenting to the ED of Singapore's largest public healthcare group. Participants will be randomly assigned to either: 1) an enhanced care arm consisting of a stepped-care intervention for panic-related anxiety; or 2) a control arm consisting of screening for panic attacks and panic disorder. Screening will be followed by baseline assessments and blocked randomization in a 1:1 ratio. Masked follow-up assessments will be conducted at 1, 3, 6, and 12 months. Clinical outcomes will be panic symptom severity and rates of panic disorder. Patient-centred outcomes will be health-related quality of life, daily functioning, psychiatric comorbidity, and health services utilization. Economic effectiveness outcomes will be the incremental cost-effectiveness ratio of the stepped-care intervention relative to screening alone.<h4>Discussion</h4>This trial will examine the impact of early intervention for patients with panic-related anxiety in the ED setting. The results will be used to propose a clinically-meaningful and cost-effective model of care for ED patients with panic-related anxiety.<h4>Trial registration</h4>ClinicalTrials.gov NCT03632356. Retrospectively registered 15 August 2018."],"journal":["BMC psychiatry"],"pagination":["795"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC9756520"],"repository":["biostudies-literature"],"pubmed_title":["Protocol for a multi-site randomized controlled trial of a stepped-care intervention for emergency department patients with panic-related anxiety."],"pmcid":["PMC9756520"],"pubmed_authors":["Ong MEH","Chin SLH","Pollack MH","Chakraborty B","Strauman TJ","Sung SC","Lim L","Annathurai A","Finkelstein EA","Lim SH"],"additional_accession":[]},"is_claimable":false,"name":"Protocol for a multi-site randomized controlled trial of a stepped-care intervention for emergency department patients with panic-related anxiety.","description":"<h4>Background</h4>Approximately 40% of Emergency Department (ED) patients with chest pain meet diagnostic criteria for panic-related anxiety, but only 1-2% are correctly diagnosed and appropriately managed in the ED. A stepped-care model, which focuses on providing evidence-based interventions in a resource-efficient manner, is the state-of-the art for treating panic disorder patients in medical settings such as primary care. Stepped-care has yet to be tested in the ED setting, which is the first point of contact with the healthcare system for most patients with panic symptoms.<h4>Methods</h4>This multi-site randomized controlled trial (RCT) aims to evaluate the clinical, patient-centred, and economic effectiveness of a stepped-care intervention in a sample of 212 patients with panic-related anxiety presenting to the ED of Singapore's largest public healthcare group. Participants will be randomly assigned to either: 1) an enhanced care arm consisting of a stepped-care intervention for panic-related anxiety; or 2) a control arm consisting of screening for panic attacks and panic disorder. Screening will be followed by baseline assessments and blocked randomization in a 1:1 ratio. Masked follow-up assessments will be conducted at 1, 3, 6, and 12 months. Clinical outcomes will be panic symptom severity and rates of panic disorder. Patient-centred outcomes will be health-related quality of life, daily functioning, psychiatric comorbidity, and health services utilization. Economic effectiveness outcomes will be the incremental cost-effectiveness ratio of the stepped-care intervention relative to screening alone.<h4>Discussion</h4>This trial will examine the impact of early intervention for patients with panic-related anxiety in the ED setting. The results will be used to propose a clinically-meaningful and cost-effective model of care for ED patients with panic-related anxiety.<h4>Trial registration</h4>ClinicalTrials.gov NCT03632356. Retrospectively registered 15 August 2018.","dates":{"release":"2022-01-01T00:00:00Z","publication":"2022 Dec","modification":"2025-06-01T00:50:43.112Z","creation":"2024-11-13T10:41:44.397Z"},"accession":"S-EPMC9756520","cross_references":{"pubmed":["36527018"],"doi":["10.1186/s12888-022-04387-z"]}}