Understanding and treating panic disorder in the primary care setting.

Area of Science:

• Primary Care Medicine
• Psychiatry
• Health Services Research

Background:

• Panic disorder has a 4% median prevalence in primary care, rising significantly in cardiac and GI patient groups.
• Patients with panic disorder are high utilizers of medical services.
• Despite its prevalence, panic disorder is frequently under-recognized and undertreated in primary care settings.

Purpose of the Study:

• To explore the challenges in managing panic disorder within primary care.
• To propose a chronic disease self-management model for improved panic disorder treatment.
• To identify key components for enhancing panic disorder management in primary care.

Main Methods:

• Literature review and expert consensus on panic disorder management in primary care.
• Analysis of current primary care models and their limitations for chronic disease management.
• Proposal of a chronic disease self-management framework tailored for panic disorder.

Main Results:

• Primary care's acute disease model and insufficient patient engagement hinder effective panic disorder management.
• A chronic disease self-management approach, emphasizing patient responsibility, can enhance treatment.
• Key interventions include assessing patient beliefs, improving treatment preparation, using standardized algorithms/scales, and provider training in brief CBT.

Conclusions:

• Panic disorder management in primary care requires a shift from an acute to a chronic disease model.
• Enhanced patient engagement and a collaborative self-management approach are crucial for improving treatment outcomes.
• Future strategies should incorporate patient-centered elements and provider training for better recognition and management of panic disorder.