Mindfulness-based intervention in patients with persistent pain in chest (MIPIC) of non-cardiac cause: a feasibility randomised control study.
Study Goal
The researchers aimed to evaluate the feasibility of mindfulness-based cognitive therapy (MBCT) in patients with non-cardiac chest pain and assess its impact on anxiety, depression, and mindfulness.
Results Summary
The study found that MBCT led to a significant reduction in general anxiety and improved mindfulness, with a trend toward better chest pain symptoms, though the sample size was small and not statistically powered.
Population
Patients with persistent non-cardiac chest pain (mean age 54.2 years, 68% women).
Effective Dosage
2-hour weekly online guided sessions for 8 weeks.
Duration
8 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness-based cognitive therapy (MBCT) | decrease | general anxiety | patients with persistent non-cardiac chest pain | - | significant reduction | #1 |
mindfulness-based cognitive therapy (MBCT) | increase | mindfulness | patients with persistent non-cardiac chest pain | - | improved | #2 |
mindfulness-based cognitive therapy (MBCT) | increase | SAQ scores | patients with persistent non-cardiac chest pain | - | trend towards improvement | #3 |
OBJECTIVE: The study evaluated the feasibility of mindfulness-based cognitive therapy (MBCT) in patients with non-cardiac chest pain by assessing their willingness to participate and adhere to the programme, and for these data to help further refine the content of MBCT for chest pain. PATIENTS AND METHODS: This prospective 2:1 randomised controlled trial compared the intervention of adapted MBCT as an addition to usual care with just usual care in controls. Among 573 patients who attended the rapid access chest pain clinic over the previous 12 months and were not diagnosed with a cardiac cause but had persistent chest pain were invited. The intervention was a 2-hour, weekly, online guided 8-week MBCT course. Compliance with attendance and the home practice was recorded. Enrolled patients completed the Seattle angina questionnaire (SAQ), Hospital Anxiety and Depression Scale, Cardiac Anxiety Questionnaire, Five-Facet Mindfulness Questionnaire, and Euro Quality of Life-5 Dimensions-5 Level at baseline assessment and after 8-week period. RESULTS: Persistent chest pain was reported by 114 patients. Of these, 33 (29%) patients with a mean age of 54.2 (±12.2) years and 68% women, consented to the study. Baseline questionnaires revealed mild physical limitation (mean SAQ, 76.8±25), high levels of anxiety (76%) and depression (53%), modest cardiac anxiety (CAQ,1.78±0.61) and mindfulness score (FFMQ, 45.5±7.3). Six patients subsequently withdrew due to bereavement, caring responsibilities and ill health. Of the remaining 27 participants, 18 in the intervention arm attended an average of 5 sessions with 61% attending ≥6 sessions. Although not statistically powered, the study revealed a significant reduction in general anxiety, improved mindfulness and a trend towards improvement in SAQ scores in the intervention arm. CONCLUSION: One-third of patients with persistent non-cardiac chest pain were willing to participate in mindfulness-based therapy. An improvement in anxiety and mindfulness was detected in this feasibility study. A larger trial is required to demonstrate improvement in chest pain symptoms.