TY - JOUR AU - Thiagalingam A. AU - Lowe H. AU - Kovoor P. AU - Atkins E. AU - Klimis H. AU - Altman M. AU - Figtree G. AU - Cheung N. AU - Denniss A. AU - Chow Clara AB -

Chest pain is common and places a significant burden on hospital resources. Many patients with undifferentiated low to intermediate risk chest pain are admitted to hospital. Rapid Access Cardiology (RAC) services are hospital co-located cardiologist-led outpatient clinics that provide rapid assessment and immediate management but not long term management. This service model is described as part of chest pain management and the National Service Framework for coronary heart disease in the United Kingdom (UK). We review the evidence on the effectiveness, safety and acceptability of RAC services. Our review finds that early assessment in RAC outpatient services of patients with suspected angina, without high-risk features suspicious of an acute coronary syndrome (ACS), is safe, can reduce hospitalisations, is cost effective, and has good medical practitioner and patient acceptability. However, the literature is limited in that the evaluation of this model of care has been only in the United Kingdom. It is potentially suited to other settings and needs further evaluation in other settings to assess its utility.

AD - University of Sydney, Sydney, NSW, Australia.
Department of Cardiology Westmead Hospital, Sydney, NSW, Australia.
The George Institute for Global Health, Sydney, NSW, Australia.
Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia.
North Shore Heart Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia.
Concord Repatriation General Hospital, Sydney, NSW, Australia.
Clinical lead, Western Sydney Integrated Care Program, Sydney, NSW, Australia.
Department of Endocrinology, Westmead Hospital, Sydney, NSW, Australia.
Western Sydney University, Sydney, NSW, Australia. AN - 27860148 BT - IInternal Medicine Journal CN - [IF]: 1.644 DP - NLM ET - 2016/11/20 J2 - Internal medicine journal LA - Eng LB - AUS
CDV
FY17 N1 - Klimis, Harry
Thiagalingam, Aravinda
Altman, Mikhail
Atkins, Emily
Figtree, Gemma
Lowe, Harry
Cheung, N Wah
Kovoor, Pramesh
Denniss, A Robert
Chow, Clara K
Review
Australia
Intern Med J. 2016 Nov 16. doi: 10.1111/imj.13334. N2 -

Chest pain is common and places a significant burden on hospital resources. Many patients with undifferentiated low to intermediate risk chest pain are admitted to hospital. Rapid Access Cardiology (RAC) services are hospital co-located cardiologist-led outpatient clinics that provide rapid assessment and immediate management but not long term management. This service model is described as part of chest pain management and the National Service Framework for coronary heart disease in the United Kingdom (UK). We review the evidence on the effectiveness, safety and acceptability of RAC services. Our review finds that early assessment in RAC outpatient services of patients with suspected angina, without high-risk features suspicious of an acute coronary syndrome (ACS), is safe, can reduce hospitalisations, is cost effective, and has good medical practitioner and patient acceptability. However, the literature is limited in that the evaluation of this model of care has been only in the United Kingdom. It is potentially suited to other settings and needs further evaluation in other settings to assess its utility.

PY - 2016 SN - 1445-5994 (Electronic)
1444-0903 (Linking) ST - Intern. Med. J.Intern. Med. J. T2 - IInternal Medicine Journal TI - A review of Rapid Access Cardiology services - Can these reduce the burden of acute chest pain on Australian and New Zealand health services? Y2 - FY17 ER -