Skip to main content

Research Repository

See what's under the surface

Advanced Search

Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial

Tyrer, Peter; Tyrer, Helen; Morriss, Richard; Crawford, Mike; Cooper, Sylvia; Yang, Min; Guo, Boliang; Mulder, Roger; Kemp, Samuel; Barrett, Barbara

Authors

Peter Tyrer

Helen Tyrer

Richard Morriss

Mike Crawford

Sylvia Cooper

Min Yang

Boliang Guo

Roger Mulder

Samuel Kemp

Barbara Barrett



Abstract

Objective: To investigate the cost-effectiveness of a modified form of cognitive behaviour therapy for recurrent non-cardiac chest pain.
Methods: We tested the effectiveness and cost-effectiveness of a modified form of cognitive behaviour therapy for chest pain (CBT-CP)(4-10 sessions) in patients who attended cardiology clinics or emergency medical services repeatedly. Patients were randomised using a remote web-based system to CBT-CP or to standard care in the clinic. Assessments were made at baseline and at six and 12 months. The primary outcome was the change in the Health Anxiety Inventory score at six months. Other clinical measures, social functioning, quality of life, and costs of services were also recorded.
Results: 68 patients were randomised with low attrition rates at 6 and 12 months with 81% of all possible assessments completed at 6 and 12 months. Although there were no significant group differences between any of the outcome measures at either 6 or 12 months, patients receiving CBT-CP had between two and three times fewer hospital bed days, outpatient appointments, and A&E attendances than those allocated to standard care and total costs per patient were £1496.49 lower, though the differences in costs were not significant. There was a small non-significant gain in quality adjusted life years (QALY's) in those allocated to CBT-CP compared with standard care (0.76 vs 0.74).
Conclusions: It is concluded that CBT-CP in the context of current hospital structures is not a viable treatment, but is worthy of further research as a potentially cost-effective treatment for non-cardiac chest pain.

Journal Article Type Article
Journal Open Heart
Electronic ISSN 2053-3624
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 4
Issue 1
Article Number e000582
APA6 Citation Tyrer, P., Tyrer, H., Morriss, R., Crawford, M., Cooper, S., Yang, M., …Barrett, B. (in press). Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial. Open Heart, 4(1), https://doi.org/10.1136/openhrt-2016-000582
DOI https://doi.org/10.1136/openhrt-2016-000582
Keywords non-cardiac chest pain, cardiac anxiety, cost-effectiveness, randomised controlled trial, health service use
Publisher URL http://openheart.bmj.com/content/4/1/e000582
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

Files

e000582.full Morriss1.pdf (930 Kb)
PDF

Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





You might also like



Downloadable Citations

;