Evaluating Outpatient Versus Hospital Care for Adults With Moderate Risk Chest Pain in Emergency Departments

What this Trial Is About

Researchers are studying the best way to evaluate patients who come to the Emergency Department with chest pain and are at moderate risk for acute coronary syndrome ACS. The trial compares rapid outpatient evaluation to traditional hospitalization to see which approach is safer, more patient-centered, and uses healthcare resources more efficiently. This study is a prospective, randomized trial enrolling 502 patients to address gaps in current care practices for chest pain patients. Participants will be randomly assigned to one of two groups. One group will receive a rapid outpatient evaluation called CARE-CP, where patients are sent home from the Emergency Department and followed up in a clinic within 72 hours to manage heart-related risk factors and decide if further testing is needed. The other group will be hospitalized for evaluation in a ward, observation unit, or emergency department boarding. This design tests whether outpatient care can reduce hospital stays without compromising safety. During the study, participants will be monitored for hospital-free days over 30 days as the main outcome, with additional follow-up up to one year. Researchers will assess factors like repeat emergency visits, rehospitalizations, rates of cardiac testing, patient satisfaction, experience, and out-of-pocket costs. The study involves clinical evaluations, questionnaires, and billing data analysis to understand the best approach for moderate risk chest pain patients. Participation may last up to one year for some measures, ensuring thorough safety and effectiveness monitoring.

CARE-CP (Testing a Cardiovascular Ambulatory Rapid Evaluation for Patients With Chest Pain)