Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial
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 w...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
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BMJ Publishing Group
2017
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| Online Access: | https://eprints.nottingham.ac.uk/40934/ |
| _version_ | 1848796166176636928 |
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| author | Tyrer, Peter Tyrer, Helen Morriss, Richard Crawford, Mike Cooper, Sylvia Yang, Min Guo, Boliang Mulder, Roger Kemp, Samuel Barrett, Barbara |
| author_facet | Tyrer, Peter Tyrer, Helen Morriss, Richard Crawford, Mike Cooper, Sylvia Yang, Min Guo, Boliang Mulder, Roger Kemp, Samuel Barrett, Barbara |
| author_sort | Tyrer, Peter |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T19:43:39Z |
| format | Article |
| id | nottingham-40934 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:43:39Z |
| publishDate | 2017 |
| publisher | BMJ Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-409342020-05-04T18:45:48Z https://eprints.nottingham.ac.uk/40934/ 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 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. BMJ Publishing Group 2017-05-16 Article PeerReviewed Tyrer, Peter, Tyrer, Helen, Morriss, Richard, Crawford, Mike, Cooper, Sylvia, Yang, Min, Guo, Boliang, Mulder, Roger, Kemp, Samuel and Barrett, Barbara (2017) Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial. Open Heart, 4 (1). e000582/1-e000582/10. ISSN 2053-3624 non-cardiac chest pain cardiac anxiety cost-effectiveness randomised controlled trial health service use http://openheart.bmj.com/content/4/1/e000582 doi:10.1136/openhrt-2016-000582 doi:10.1136/openhrt-2016-000582 |
| spellingShingle | non-cardiac chest pain cardiac anxiety cost-effectiveness randomised controlled trial health service use Tyrer, Peter Tyrer, Helen Morriss, Richard Crawford, Mike Cooper, Sylvia Yang, Min Guo, Boliang Mulder, Roger Kemp, Samuel Barrett, Barbara Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial |
| title | Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial |
| title_full | Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial |
| title_fullStr | Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial |
| title_full_unstemmed | Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial |
| title_short | Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial |
| title_sort | clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: a multicentre, randomised controlled trial |
| topic | non-cardiac chest pain cardiac anxiety cost-effectiveness randomised controlled trial health service use |
| url | https://eprints.nottingham.ac.uk/40934/ https://eprints.nottingham.ac.uk/40934/ https://eprints.nottingham.ac.uk/40934/ |