Psychological interventions for management of non-specific chest pain

Cognitive-behavioural psychological interventions may benefit patients with non-specific, non-cardiac chest pain.

A Cochrane review included 17 studies with a total of 1 006 subjects. There was a significant reduction in reports of chest pain in the first three months following the intervention (RR 0.70, 95% CI 0.53 to 0.92; statistical heterogeneity, I²=59%). This was maintained from 3 to 9 months afterwards (RR 0.59, 95% CI 0.45 to 0.76). There was also a significant increase in the number of chest pain free days up to three months following the intervention (MD 3.00, 95% CI 0.23 to 5.77; statistical heterogeneity, I²=68%). This was associated with reduced chest pain frequency (MD -2.26, 95% CI -4.41 to -0.12; statistical heterogeneity, I²=94%) but there was no evidence of effect of treatment on chest pain frequency from 3 to 12 months (MD -0.81, 95% CI -2.35 to 0.74; statistical heterogeneity, I²=75%). There was no effect on severity (MD -4.64, 95% CI -12.18 to 2.89; statistical heterogeneity, I²=65%) up to 3 months after the intervention). Wide variability in outcome measures made integration of studies for secondary outcome measures difficult.

Comment: The quality of evidence is downgraded by study limitations (lack of blinding), and by inconsistency (unexplained variability in results).

Ədəbiyyat

1. Kisely SR, Campbell LA, Yelland MJ et al. Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy. Cochrane Database Syst Rev 2015;(6):CD004101.