JAMA Internal Medicine Author Interviews
Sep 28, 2026 · 12 min · 7 segments
Interview with Paul I. Musey Jr, MD, MS, author of Telehealth Treatment of Anxiety in Patients With Low-Risk Chest Pain in the Emergency Department: The PACER Randomized Clinical Trial, and Jeffrey A…
Ilana RichmanHost
Paul MuseyGuest
Jeffrey KlineGuest
PACER stands for Patient-Centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room.
PACER was a randomized controlled trial that evaluated the comparative effectiveness of three different strategies for addressing anxiety among patients with low-risk chest pain in the emergency department.
The trial randomized patients presenting to the ED who were unlikely to have cardiac chest pain, who also had significant anxiety to one of three treatment strategies.
So the first strategy was enhanced follow-up with PCP, where patients were instructed to follow up with their provider.
There was some communication with the PCP about the presenting condition and some patient education.
The second strategy was a self-guided cognitive behavioral therapy intervention provided over a web-based interface, along with peer support to promote engagement.
And the third strategy was more traditional, therapist-guided cognitive behavioral therapy delivered via telehealth.
So before we get into the findings from the study, I want to first start by talking about the larger challenge of low-risk chest pain.
PACER stands for Patient-Centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room.
PACER was a randomized controlled trial that evaluated the comparative effectiveness of three different strategies for addressing anxiety among patients with low-risk chest pain in the emergency department.
The trial randomized patients presenting to the ED who were unlikely to have cardiac chest pain, who also had significant anxiety to one of three treatment strategies.
So the first strategy was enhanced follow-up with PCP, where patients were instructed to follow up with their provider.
There was some communication with the PCP about the presenting condition and some patient education.
The second strategy was a self-guided cognitive behavioral therapy intervention provided over a web-based interface, along with peer support to promote engagement.
And the third strategy was more traditional, therapist-guided cognitive behavioral therapy delivered via telehealth.
So before we get into the findings from the study, I want to first start by talking about the larger challenge of low-risk chest pain.
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