Interdisciplinary Treatment of Morbidity in Benign Chest Pain

Abstract

This study tested the hypothesis that functional morbidity in benign chest pain can be modified independently of symptoms through interdisciplinary medical and cognitive-behavioral intervention. Analyses used data collected in a sixteen-week trial of interdisciplinary treatment for disability in benign chest pain. One hundred four chest pain patients having normal coronary arteriograms (NCA) (n = 14) or mitral valve prolapse (MVP) with no other known cardiac or arterial disease (n = 90) were assigned to individual treatment, group treatment, self-monitoring attention control, or a wait-list control group. Results indicate that interdisciplinary intervention, in group or individualized format, was successful for improving short-term and long-term (follow-up range = six to sixteen months) functional status, in both MVP and NCA patients. Correlation analysis indicated that functional improvements were not dependent on reductions in the frequency of symptoms. In fact, significant reductions in disability were obtained in those treated patients (13 of 43) who reported no reduction, or an actual increase, in the frequency of chest symptoms. These data indicate that disability in benign chest pain may be modified independently of symptoms by an integration of medical and cognitive-behavioral strategies.

Review article: the current treatment of non‐cardiac chest pain

“…Cognitive behavioural therapy (CBT) emphasises cognitive methods by which patients examine beliefs regarding symptoms and undergo a process of adjustment of these beliefs (Table ). The role of CBT in the treatment of NCCP has been evaluated in several randomised controlled trials . One of the earliest studies was conducted in 31 patients with NCCP who were randomised to either immediate CBT ( n = 14) or assessment only ( n = 17).…”

It's Not Your Heart: Group Treatment for Non-Cardiac Chest Pain

“…They also had improvement in anxiety and depression scores, improved exercise tolerance, and decreased disability ratings. Cott et al (1992) compared individual and group CBT for NCCP with self-monitoring and wait list control. Short and long-term (6 and 16 months) functional status improved equally in both the individual and group CBT treatment arms compared with the control groups.…”

Achieving Interprofessional Practice in Cardiac Rehabilitation

“…Authors do not clearly define interprofessional practices or explain how such teams are structured, communicate with each other, and/or collaborate. [8][9][10][11][12][13][14][15] Cott et al 9 used the term interdisciplinary to describe a treatment for disability in benign chest pain to reduce functional morbidity. Patients (n ϭ 104) experiencing benign chest pain with normal coronary arteriograms (n ϭ 14) or mitral valve prolapse with no other known cardiac or arterial disease (n ϭ 90) were randomly assigned to either an individual interdisciplinary cognitivebehavioral treatment group, with an interdisciplinary cognitive-behavioral education format and self-monitoring attention control, or a wait-list control group.…”

“…However, these authors did not specifically identify how their intervention was interdisciplinary in nature, nor did they identify whether it was the medical intervention alone or the interdisciplinary intervention that produced the outcome. 9 Other authors have stressed the importance of an interdisciplinary and/or interprofessional team approach in home 10 and comprehensive cardiac rehabilitation programs and in the development of integrated community pathways following myocardial infarction 11 and heart failure programs. 12 Kammer 13 stressed an interprofessional approach to role development, such as an inclusion of a pharmacist in a cardiac rehabilitation program.…”

“…Design Focus Critique Carbone 15 Cott et al 9 Graybeal and MocciaSattler 12 Green and Lydon 10 Henriksen and Rosenqvist 14 Kammer 13 Young et al 11…”