Treating panic disorder in primary care: a collaborative care intervention

2002 ◽  
Vol 24 (3) ◽  
pp. 148-155 ◽  
Author(s):  
Michelle G. Craske ◽  
Peter Roy-Byrne ◽  
Murray B. Stein ◽  
Cathy Donald-Sherbourne ◽  
Alexander Bystritsky ◽  
...  
Keyword(s):  
Primary Care ◽  
Panic Disorder ◽  
Collaborative Care ◽  
Care Intervention

scholarly journals Using RE-AIM to examine the potential public health impact of an integrated collaborative care intervention for weight and depression management in primary care: Results from the RAINBOW trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248339
Author(s):  
Megan A. Lewis ◽  
Laura K. Wagner ◽  
Lisa G. Rosas ◽  
Nan Lv ◽  
Elizabeth M. Venditti ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Collaborative Care ◽  
Health Impact ◽  
Public Health Impact ◽  
Integrative Approach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Care Intervention ◽  
The Impact

Background An integrated collaborative care intervention was used to treat primary care patients with comorbid obesity and depression in a randomized clinical trial. To increase wider uptake and dissemination, information is needed on translational potential. Methods The trial collected longitudinal, qualitative data at baseline, 6 months (end of intensive treatment), 12 months (end of maintenance treatment), and 24 months (end of follow-up). Semi-structured interviews (n = 142) were conducted with 54 out of 409 randomly selected trial participants and 37 other stakeholders, such as recruitment staff, intervention staff, and clinicians. Using a Framework Analysis approach, we examined themes across time and stakeholder groups according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Results At baseline, participants and other stakeholders reported being skeptical of the collaborative care approach related to some RE-AIM dimensions. However, over time they indicated greater confidence regarding the potential for future public health impact. They also provided information on barriers and actionable information to enhance program reach, effectiveness, adoption, implementation, and maintenance. Conclusions RE-AIM provided a useful framework for understanding how to increase the impact of a collaborative and integrative approach for treating comorbid obesity and depression. It also demonstrates the utility of using the framework as a planning tool early in the evidence-generation pipeline.

Incremental cost-effectiveness of a collaborative care intervention for panic disorder

2006 ◽  
Vol 36 (3) ◽  
pp. 353-363 ◽  
Author(s):  
WAYNE KATON ◽  
JOAN RUSSO ◽  
CATHY SHERBOURNE ◽  
MURRAY B. STEIN ◽  
MICHELLE CRASKE ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Panic Disorder ◽  
Incremental Cost ◽  
Usual Care ◽  
Moderate Increase ◽  
Patient Costs ◽  
Care Intervention ◽  
Life Years ◽  
Primary Care Patients

Background. Panic disorder is a prevalent, often disabling, disorder among primary-care patients, but there are large gaps in quality of treatment in primary care. This study describes the incremental cost-effectiveness of a combined cognitive behavioral therapy (CBT) and pharmacotherapy intervention for patients with panic disorder versus usual primary-care treatment.Method. This randomized control trial recruited 232 primary-care patients meeting DSM-IV criteria for panic disorder from March 2000 to March 2002 from six primary-care clinics from university-affiliated clinics at the University of Washington (Seattle) and University of California (Los Angeles and San Diego). Patients were randomly assigned to receive either treatment as usual or a combined CBT and pharmacotherapy intervention for panic disorder delivered in primary care by a mental health therapist. Intervention patients had up to six sessions of CBT modified for the primary-care setting in the first 12 weeks, and up to six telephone follow-ups over the next 9 months. The primary outcome variables were total out-patient costs, anxiety-free days (AFDs) and quality adjusted life-years (QALYs).Results. Relative to usual care, intervention patients experienced 60·4 [95% confidence interval (CI) 42·9–77·9] more AFDs over a 12-month period. Total incremental out-patient costs were $492 higher (95% CI $236–747) in intervention versus usual care patients with a cost per additional AFD of $8.40 (95% CI $2.80–14.0) and a cost per QALY ranging from $14158 (95% CI $6791–21496) to $24776 (95% CI $11885–37618). The cost per QALY estimate is well within the range of other commonly accepted medical interventions such as statin use and treatment of hypertension.Conclusions. The combined CBT and pharmacotherapy intervention was associated with a robust clinical improvement compared to usual care with a moderate increase in ambulatory costs.

scholarly journals Symptom trajectories in patients with panic disorder in a primary care intervention: Results from a randomized controlled trial (PARADISE)

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Karoline Lukaschek ◽  
Thomas S. Hiller ◽  
Ulrike Schumacher ◽  
Tobias Teismann ◽  
Jörg Breitbart ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Controlled Trial ◽  
Panic Disorder ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Symptom Trajectories ◽  
Care Intervention

A Randomized Effectiveness Trial of Collaborative Care for Patients With Panic Disorder in Primary Care

2001 ◽  
Vol 58 (9) ◽  
pp. 869 ◽  
Author(s):  
Peter P. Roy-Byrne ◽  
Wayne Katon ◽  
Deborah S. Cowley ◽  
Joan Russo
Keyword(s):  
Primary Care ◽  
Panic Disorder ◽  
Collaborative Care ◽  
Effectiveness Trial

scholarly journals Age differences in treatment response to a collaborative care intervention for anxiety disorders

2013 ◽  
Vol 203 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Julie Loebach Wetherell ◽  
Andrew J. Petkus ◽  
Steven R. Thorp ◽  
Murray B. Stein ◽  
Denise A. Chavira ◽  
...  
Keyword(s):  
Older Adults ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Social Anxiety Disorder ◽  
Collaborative Care ◽  
Generalised Anxiety Disorder ◽  
Younger Adults ◽  
Care Intervention

BackgroundSome data suggest that older adults with anxiety disorders do not respond as well to treatment as do younger adults.AimsWe examined age differences in outcomes from the Coordinated Anxiety Learning and Management (CALM) study, an effectiveness trial comparing usual care to a computer-assisted collaborative care intervention for primary care patients with panic disorder, generalised anxiety disorder, post-traumatic stress disorder (PTSD), and/or social anxiety disorder. This is the first study to examine the efficacy of a collaborative care intervention in a sample that included both younger and older adults with anxiety disorders. We hypothesised that older adults would show a poorer response to the intervention than younger adults.MethodWe examined findings for the overall sample, as well as within each diagnostic category (clinicaltrials.gov identifier: NCT00347269).ResultsThe CALM intervention was more effective than usual care among younger adults overall and for those with generalised anxiety disorder, panic disorder and social anxiety disorder. Among older adults, the intervention was effective overall and for those with social anxiety disorder and PTSD but not for those with panic disorder or generalised anxiety disorder. The effects of the intervention also appeared to erode by the 18-month follow-up, and there were no significant effects on remission among the older adults.ConclusionsThese results are consistent with the findings of other investigators suggesting that medications and psychotherapy for anxiety disorders may not be as effective for older individuals as they are for younger people.

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