title: Feasibility and outcome of the implementation of a screening program for panic disorder in noncardiac chest pain patients in cardiac emergency department routine care.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Wicher A
authors.initials: WA
authors.lastname: Bokma
authors.affiliation: 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.
authors.forename: Neeltje M
authors.initials: NM
authors.lastname: Batelaan
authors.affiliation: Department of Cardiology, VU-University Medical Center, De Boelelaan 1117, 1081 HZ Amsterdam, the Netherlands. Electronic address: am.beek@vumc.nl.
authors.forename: Aernout M
authors.initials: AM
authors.lastname: Beek
authors.affiliation: 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.
authors.forename: Annette D
authors.initials: AD
authors.lastname: Boenink
authors.affiliation: 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.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Smit
authors.affiliation: 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.
authors.forename: Anton J L M
authors.initials: AJ
authors.lastname: van Balkom
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016507:Cardiology Service, Hospital; D002637:Chest Pain / Q000523:psychology*; D015331:Cohort Studies; D003955:Diagnostic Tests, Routine; D004636:Emergency Service, Hospital; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D016584:Panic Disorder / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cardiology service, hospital; Feasibility studies; Noncardiac chest pain; Panic disorder; Screening