Panic Disorder in Primary Care: The Effects of a Team-Based Intervention-a Cluster-Randomized Trial
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Panic Disorder in Primary Care: The Effects of a Team-Based Intervention-a Cluster-Randomized Trial. / Gensichen, Jochen; Hiller, Thomas S; Breitbart, Jörg; Brettschneider, Christian; Teismann, Tobias; Schumacher, Ulrike; Lukaschek, Karoline; Schelle, Mercedes; Schneider, Nico; Sommer, Michael; Wensing, Michel; König, Hans-Helmut; Margraf, Jürgen; Jena Paradies Study Group.
In: DTSCH ARZTEBL INT, Vol. 116, No. 10, 08.03.2019, p. 159-166.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Panic Disorder in Primary Care: The Effects of a Team-Based Intervention-a Cluster-Randomized Trial
AU - Gensichen, Jochen
AU - Hiller, Thomas S
AU - Breitbart, Jörg
AU - Brettschneider, Christian
AU - Teismann, Tobias
AU - Schumacher, Ulrike
AU - Lukaschek, Karoline
AU - Schelle, Mercedes
AU - Schneider, Nico
AU - Sommer, Michael
AU - Wensing, Michel
AU - König, Hans-Helmut
AU - Margraf, Jürgen
AU - Jena Paradies Study Group
PY - 2019/3/8
Y1 - 2019/3/8
N2 - BACKGROUND: We evaluated a team-based program of exercises for patients with panic disorder with or without agoraphobia (PDA) in primary care.METHODS: 419 patients with PDA (mean age 46.2 years, standard deviation 14.4 years; 74% female) were included in this cluster-randomized, controlled intervention trial. The patients were blinded with respect to their group assignment at baseline. Patients in the intervention group (36 primary-care practices, 230 patients) underwent a 23-week exercise program combined with case management, while patients in the control group (37 practices, 189 patients) received standard care. Symptoms of anxiety (according to the Beck Anxiety Inventory, BAI) at six months were the primary endpoint. Patients were followed up at six months (n = 338, 81%) and at twelve months (n = 318, 76%). The analysis was by intention to treat.RESULTS: Symptoms of anxiety improved to a significantly greater extent in the intervention group (p = 0.008). The intergroup dif- ference in the reduction of the BAI score (range: 0-63) was 3.0 points (95% confidence interval [-5.8; -0.2]) at six months and 4.0 points [-6.9; -1.2] at twelve months. In the intervention group, there was a significantly greater reduction in the frequency of panic attacks (p = 0.019), in avoidant behavior (p = 0.016), and in depressiveness (p<0.001), as well as a greater improvement of the quality of treatment (p<0.001).CONCLUSION: In primary-care patients who have panic disorder with or without agoraphobia, a team-based exercise program combined with case management can improve symptoms to a greater extent than standard primary-care treatment.
AB - BACKGROUND: We evaluated a team-based program of exercises for patients with panic disorder with or without agoraphobia (PDA) in primary care.METHODS: 419 patients with PDA (mean age 46.2 years, standard deviation 14.4 years; 74% female) were included in this cluster-randomized, controlled intervention trial. The patients were blinded with respect to their group assignment at baseline. Patients in the intervention group (36 primary-care practices, 230 patients) underwent a 23-week exercise program combined with case management, while patients in the control group (37 practices, 189 patients) received standard care. Symptoms of anxiety (according to the Beck Anxiety Inventory, BAI) at six months were the primary endpoint. Patients were followed up at six months (n = 338, 81%) and at twelve months (n = 318, 76%). The analysis was by intention to treat.RESULTS: Symptoms of anxiety improved to a significantly greater extent in the intervention group (p = 0.008). The intergroup dif- ference in the reduction of the BAI score (range: 0-63) was 3.0 points (95% confidence interval [-5.8; -0.2]) at six months and 4.0 points [-6.9; -1.2] at twelve months. In the intervention group, there was a significantly greater reduction in the frequency of panic attacks (p = 0.019), in avoidant behavior (p = 0.016), and in depressiveness (p<0.001), as well as a greater improvement of the quality of treatment (p<0.001).CONCLUSION: In primary-care patients who have panic disorder with or without agoraphobia, a team-based exercise program combined with case management can improve symptoms to a greater extent than standard primary-care treatment.
KW - Journal Article
U2 - 10.3238/arztebl. 2019.01592019.0159
DO - 10.3238/arztebl. 2019.01592019.0159
M3 - SCORING: Journal article
C2 - 30995952
VL - 116
SP - 159
EP - 166
JO - DTSCH ARZTEBL INT
JF - DTSCH ARZTEBL INT
SN - 1866-0452
IS - 10
ER -
