Clinical trial NCT03188861: Systematic Screening for Comorbid Psychological Conditions in Cardiac ACSC Patients With Multimorbidity in the ED
Official title: Systematic Screening for Comorbid Psychological Conditions in Cardiac Ambulatory Care Sensitive Conditions (ACSC) Patients With Multimorbidity in the Emergency Departments (ED)
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Depression
Anxiety
Somatoform Disorders
Alcohol Abuse
Keywords: mental health conditions in ACSC patients
multimorbidity
health care utilization
Lead sponsor: Charite University, Berlin, Germany
Sponsor class: OTHER
Collaborators: name: German Federal Ministry of Education and Research
First posted: 2017-06-16
Enrollment: 650
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The study population comprises patients admitted to an ED in Berlin-Mitte during the study period from 01.06.2017 to 31.05.2018 with cardiac complaints who are admitted to the hospital or discharged from ED. The study focusses especially on older and multimorbid patients. Multimorbidity is defined as the presence of more than two chronic diagnoses.

Brief summary: EMASPOT assesses the prevalence and impact of mental health conditions in multimorbid emergency patients with cardiac ACSC on transsectoral utilisation of health care services.

Detailed description: The specific aims of EMASPOT are primarily to determine the prevalence of mental health conditions (MHC) (i.e., symptoms of depression, anxiety, somatoform disorders, and alcohol abuse) in patients with multimorbidity and cardiac ACSC in a prospective cohort study.

The study population comprises patients admitted to an ED in Berlin-Mitte during the study period from 01.06.2017 to 31.05.2018 with cardiac complaints who are admitted to the hospital or discharged from ED. The study focusses especially on older and multimorbid patients. Multimorbidity is defined as the presence of more than two chronic diagnoses.

After having given informed consent patients are enrolled in the study and interviewed by a study nurse. Self-reported symptom burden for depression, anxiety disorders, somatoform disorders, alcohol abuse as well as frequency of utilization of health care services are assessed. Medical data will be abstracted from medical charts and include somatic comorbidities, medication and diagnostic procedures and interventions during hospitalization.

Individual semi-structured interviews will be conducted with 30 patients to assess the treatment expectations and underlying motives for ED-visits, as well as with 30 health care professionals to investigate perceptions of challenges regarding identification and treatment of patients with MHC.

All patients will have a 6-months follow-up after discharge from the ED. The follow-up is conducted either by telephone calls, e-mail or via mail. The follow-up data will include mental health conditions as assessed at baseline, frequency of utilization of health care services and health-related quality of life.

Eligibility criteria: Inclusion Criteria:

* Patients presenting to one of the EDs in Berlin-Mitte due to cardiac complaints (acute heart failure, angina pectoris, dyspnea, arrhythmias)
* Age 50 and older

Exclusion Criteria:

* Age 49 and younger
* Inability to give written informed consent (cognitive impairment, legal guardianship)
* Insufficient language skills to complete the questionnaire in one of the provided languages (German, English, Russian, Turkish)

Primary outcomes:
measure: Mental health conditions
timeFrame: Baseline
Secondary outcomes:
measure: Prevalence of mental disorders
timeFrame: Baseline
measure: Health outcomes
timeFrame: 6-months follow-up
measure: Utilization of health care systems
timeFrame: Baseline
measure: Utilization of health care systems
timeFrame: 6-months follow-up
measure: Expectations towards ED-care, semi-structured qualitative interviews
timeFrame: Baseline
Other outcomes:
Locations:
city: Berlin
country: Germany
facility: Division of Emergency Medicine, Charité University Hospital
Study officials:
affiliation: Division of Emergency Medicine, Charité University Hospital Berlin
name: Martin Möckel, Prof. Dr.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Schneider A, Riedlinger D, Pigorsch M, Holzinger F, Deutschbein J, Keil T, Mockel M, Schenk L. Self-reported health and life satisfaction in older emergency department patients: sociodemographic, disease-related and care-specific associated factors. BMC Public Health. 2021 Jul 21;21(1):1440. doi: 10.1186/s12889-021-11439-8.