A randomized controlled trial of a brief educational and psychological intervention for patients presenting to a cardiac clinic with palpitation

Psychol Med. 2002 May;32(4):699-706. doi: 10.1017/s0033291702005536.

Abstract

Background: We sought to determine whether a brief psycho-educational intervention reduced disability in patients with benign palpitation.

Method: In a pragmatic randomized controlled trial within a cardiology clinic at a district general hospital, 80 consecutive patients diagnosed as having benign palpitation--either palpitation due to awareness of extrasystoles or sinus rhythm--with associated distress or disability were randomized to an intervention group (usual care plus nurse-delivered intervention based on cognitive-behavioural principles) or to a control group (usual care). Principal outcome was difference in proportion of participants with good or excellent researcher-rated activity levels at 3 months. Subsidiary outcomes were self-rated symptoms, distress and disability, researcher-rated unmet treatment needs.

Results: The principal outcome showed a statistically and clinically significant benefit for the intervention group, with a number needed to treat of 3 (95% CIs 2 to 7). All but one subsidiary outcomes also showed a difference in favour of the intervention group, and several differences reached statistical significance. Significantly more of the control group had unmet treatment needs at 3 months.

Conclusions: A brief, nurse-delivered, psycho-educational intervention, was an effective treatment for benign palpitation. Further evaluation, including assessment of cost-effectiveness, is needed. The findings have application to the care of patients presenting with other types of 'unexplained' medical symptoms.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiac Complexes, Premature / psychology*
  • Cognitive Behavioral Therapy*
  • Combined Modality Therapy
  • England
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurocirculatory Asthenia / psychology
  • Neurocirculatory Asthenia / therapy*
  • Patient Care Team
  • Patient Education as Topic*
  • Psychotherapy, Brief*
  • Sick Role
  • Treatment Outcome