Key result
Panic management initiated in the emergency department presented a superior incremental cost-effectiveness ratio of $124.05 (95% CI, $54.63-$314.57) per severity score change compared with usual care.
Why the study?
Do brief cognitive-behavioral therapies or pharmacotherapy improve cost-effectiveness and panic disorder severity in patients with noncardiac chest pain compared with usual care?
Do brief cognitive-behavioral therapies or pharmacotherapy improve cost-effectiveness and panic disorder severity in patients with noncardiac chest pain compared with usual care?
Panic management is a promising, cost-effective intervention for emergency department patients presenting with noncardiac chest pain and panic disorder.
May support considering panic management in EDs for panic disorder; leaves open need for randomized trials before practice change.
The aim of this study was to assess the incremental cost-effectiveness ratios (ICERs) of two brief cognitive-behavioral therapy (CBT)-based interventions and a pharmacological treatment, compared with usual care, initiated in the emergency department (ED) for individuals with panic disorder (PD) with a chief complaint of noncardiac chest pain. A total of 69 patients were followed up to 6 months. The primary outcome variables were direct and indirect costs of treatment and PD severity. Panic management (PM) had an ICER of $124.05, per the Anxiety Disorders Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, severity score change (95% confidence interval [CI], $54.63-$314.57), compared with pharmacotherapy (paroxetine), with an ICER of $213.90 (95% CI, $133.51-$394.94), and brief CBT, with an ICER of $309.31 (95% CI, $151.27-$548.28). The pharmacological and CBT interventions were associated with a greater clinical improvement compared with usual care at posttest. PM presented a superior ICER, suggesting that it may be a promising treatment option to implement in EDs.
No takes yet. Share an insight, caveat, or question.
Poirier-Bisson et al. (2013) studied Panic disorder and noncardiac chest pain (n=69). Panic management, brief CBT, or pharmacotherapy (paroxetine) vs. Usual care was evaluated on Direct and indirect costs of treatment and panic disorder severity (ICER $124.05, 95% CI 54.63-314.57). Panic management initiated in the emergency department presented a superior incremental cost-effectiveness ratio of $124.05 (95% CI, $54.63-$314.57) per severity score change compared with usual care.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: