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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, Michael ; Cooper, Sylvia ; Yang, Min ; Guo, Boliang ; Mulder, Roger T ; Kemp, Samuel ; Barrett, Barbara

Open Heart, 2017, Vol.4(1) [Periódico revisado por pares]

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  • Título:
    Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial
  • Autor: Tyrer, Peter ; Tyrer, Helen ; Morriss, Richard ; Crawford, Michael ; Cooper, Sylvia ; Yang, Min ; Guo, Boliang ; Mulder, Roger T ; Kemp, Samuel ; Barrett, Barbara
  • Assuntos: Health Care Delivery, Economics And Global Health Care ; 1506 ; Non-Cardiac Chest Pain ; Cardiac Anxiety ; Cost-Effectiveness ; Randomised Controlled Trial ; Health Service Use
  • É parte de: Open Heart, 2017, Vol.4(1)
  • Descrição: Objective To investigate the cost-effectiveness of a modified form of cognitive behavioural therapy (CBT) for recurrent non-cardiac chest pain. Methods We tested the effectiveness and cost-effectiveness of a modified form of CBT 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 6 months and 12 months. The primary outcome was the change in the Health Anxiety Inventory Score at 6 months. Other clinical measures, social functioning, quality of life and costs of services were also recorded. Results Sixty-eight patients were randomised with low attrition rates at 6 months and 12 months with 81% of all possible assessments completed at 6 months and 12 months. Although there were no significant group differences between any of the outcome measures at either 6 months 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 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. Trial registration number ISRCTN 14711101.
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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