Integrated Multidisciplinary Approach to Acute Chest Pain: Perspectives From Family Medicine, Emergency Medicine, and Internal Medicine.

BACKGROUND

Acute chest discomfort is a common clinical problem that has to be well understood and managed collaboratively by specialists from many fields of medicine.

OBJECTIVE

This study aimed to explore and evaluate the perspectives of healthcare professionals in family, emergency, and internal medicine regarding the management of acute chest pain, with a specific focus on diagnostic practices, interdisciplinary collaboration, and protocol adherence to establish best practices for a unified approach.

METHODOLOGY

This cross-sectional study, conducted from June 2022 to July 2024, included 218 healthcare professionals with over a year of experience in family, emergency, and internal medicine, selected through convenient sampling from hospitals such as Lady Reading Hospital, Hayatabad Medical Complex, Mardan Medical Complex, and Government Mian Meer Hospital. Data was collected through structured questionnaires covering demographics, clinical protocols, inter-disciplinary communication, and management challenges, complemented by semi-structured interviews for deeper insights. Statistical analysis was performed using SPSS version 26, with chi-square tests comparing responses across specialties, considering p < 0.05 as statistically significant.  Results: The results showed that emergency medicine practitioners had the highest use of diagnostic tools, with 80 out of 80 (100%) using electrocardiogram (ECG) and 78 out of 80 (97.5%) using troponin tests, compared to 60 out of 70 (85.71%) and 40 out of 70 (57.14%) in family medicine (p < 0.001 for both). Additionally, 70 out of 80 (87.5%) in emergency medicine reported time constraints affecting management. Communication barriers were noted by 50 out of 80 (62.5%) in emergency medicine and 45 out of 70 (64.29%) in family medicine. Interdisciplinary collaboration was reported at 50 out of 70 (71.43%) in family medicine and 60 out of 80 (75%) in emergency medicine. A lack of standardized protocols was especially high in internal medicine, impacting 65 out of 68 (95.59%) participants (p<0.001).

CONCLUSION

Emergency medicine professionals consistently utilize diagnostic tools like ECGs and troponin tests more frequently, reflecting their time-sensitive clinical environment, but also report significant time constraints. In contrast, internal medicine practitioners, who generally have more years of experience, reported the highest adherence to management protocols, yet they also identified a lack of standardized guidelines as a major barrier. Family medicine professionals, while showing strong interdisciplinary collaboration, had lower utilization rates of advanced diagnostic tools, which may impact early decision-making. These disparities underline the need for unified protocols and improved communication pathways across specialties to enhance diagnostic accuracy and streamline management.