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Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: A multicentre, randomised controlled trial
Morriss, Richard K. Guo, Boliang
Morriss, Richard K.
Guo, Boliang
Abstract
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. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017.
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2017
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Tyrer, P., Tyrer, H., Morriss, R., Crawford, M., Cooper, S., Yang, M., Guo, B., Mulder, R. T., Kemp, S. & Barrett, B. (2017). Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: A multicentre, randomised controlled trial. Open Heart, 4(1), pp.1-11.
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© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/