None listed
Conditions
Brief summary
The primary aim of the study is to reduce the number of ED re-presentations in the target population. Specifically, the aim of this study is to determine whether there are differences in outcomes for individuals who present to ED with non-cardiac chest pain and receive psychological intervention vs those who receive usual care, in relation to ED re-presentations over a 6-month period. The secondary aim is to study if the intervention will result in an improvement in other patient outcomes, such as symptomatology, the quality of life and reduction in psychological distress and whether or not this intervention is cost effective This is a Single-blind randomised controlled trial in which the assessor is blind to treatment vs standard care condition. All individuals who meet the selection criteria will be invited to participate in the research. Consenting participants who meet the selection criteria, will be randomly allocated to either -: A) Psychological treatment group consisting of 6 sessions of psychotherapy over 6-8 weeks, which will be conducted by a fully qualified Psychologist (Director of Psychology, THHS) B) Usual care/ Wait list controls (Wait list controls have been included to ensure that all patients in the trial have access to treatment eventually should they so desire, since this treatment is evidence based) Outcomes will be assessed for both groups at baseline, 8 weeks; 16 weeks and 24 weeks.
Interventions
There will be an information sheet provided at ED and a client consent form with information about the trial and that all participation is voluntary. The patients will also be provided information about the treatment and that they have a right to withdraw at any point in time. The intervention will consist of Cognitive Behaviour Therapy which will target non cardiac chest pain as a symptoms
it will be delivered by a fully registered psychologist
it will be delivered as a face to face interventi
There will be an information sheet provided at ED and a client consent form with information about the trial and that all participation is voluntary. The patients will also be provided information about the treatment and that they have a right to withdraw at any point in time. The intervention will consist of Cognitive Behaviour Therapy which will target non cardiac chest pain as a symptoms it will be delivered by a fully registered psychologist it will be delivered as a face to face intervention for 6 sessions over 6 to 8 weeks the duration of any single session will generally be 1 hour per week the intervention will be delivered from the Townsville Hospital assessing the adherence to intervention will be a part of the psychotherapy
Sponsors
The Townsville Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
All patients aged 18 to 65yrs who present to THHS ED with a discharge diagnosis of non-cardiac chest pain (NCCP) during the study period,.
Exclusion criteria
Since therapy involves providing standard psychotherapy which involves a fair degree of proficiency with English language, it is proposed that the following are excluded from this RCT in the interest of controlling for relevant variables: • Individuals with limited proficiency in English language or with sensory or other impairment which impacts on expression and comprehension of English language • Individuals from indigenous or culturally and linguistically diverse backgrounds In addition it is suggested that individuals with the following conditions be excluded from this study i. Those who have an underlying cardiac pathology – for the purpose of the study this is defined as individuals who have a diagnosed coronary artery disease This is because this represents a high-risk group who might need to re-present to the ED and therefore any gains made due to psychotherapy might not be best reflected through ED representations as the primary measure of the intervention's success. ii. Individuals who have a co-morbid neurological condition: This includes a group of individuals who have had stroke or a space occupying lesion or those with a history of seizure disorder. Once again this represents a high-risk group who might need to re-present to the ED and therefore any gains made due to psychotherapy might not be best reflected through ED representations as the primary measure of the intervention's success iii. Individuals who have a co-morbid psychiatric condition for which they are on psychotropic medication:
Outcome results
None listed