Implementation and application of a structured training for emergency room physicians for the recognition and diagnosis of psychological comorbidities in chest pain patients after exclusion of a myocardial infarction or acute life-threatening illnesses in the emergency department
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EMASPOT II will determine the prevalence of Mental Health Conditions (Depression, Anxiety and Somatoform Disorders) (MHC) in emergency department patients with chest pain after a structured training of emergency physicians in the recognition and diagnosis of MHC.
Mental health conditions such as depression and anxiety are common and have a significant impact on physical health, quality of life and healthcare costs; however, they are often underdiagnosed not only in routine medical care but especially in the emergency department. MHC affect patients' functional status and ability to self-manage, especially in older patients, and are associated with higher healthcare utilisation and urgent and unscheduled healthcare use.
The proportion of patients with chest pain (after exclusion of infarction or other acute life-threatening conditions) and (suspected) MHC will be determined using routine data from the participating emergency departments. The aim is to enable a higher correspondence between treatment needs and expectations and offers in the acute care of multimorbid elderly patients with mental illness.
The study will be conducted in a mixed-methods design. In addition to the implementation and evaluation of a psychocardiology training programme, qualitative interviews will be conducted with the physicians participating in the training. The analysis of the prevalence of patients with MHC 6 months before and 6 months after the psychocardiological training programme will be carried out on the basis of the routine data from the emergency departments.
Primary research objective:
- To develop, test and implement a psychocardiology training programme for emergency department physicians to increase awareness of psychological symptoms and illnesses in primary cardiac patients in the emergency department. Therefore, the emergency room visit can contribute to the identification of psychologically distressed patients and appropriate care pathways can be identified or initiated. Overall, this contributes to improved patient management and high-quality emergency care.
Secondary research objectives:
- To develop and implement a psychocardiological training programme.
- Validation of mental health problems through a structured clinical interview in patients with chest pain
- To organise follow-up and a more in-depth clinical assessment of patients by a mental health specialist.
- Identify clinicians' experiences of diagnosing mental health conditions (MHC) in patients in the emergency department
- Identify patients' experiences of in-depth clinical assessment for MHCs
- Analyse MHC and other conditions in subgroups of multimorbid patients >49 years of age
- Dr. rer. nat. Dipl.-Psych. Andrea Figura, Medical clinic with focus on psychosomatics, Link