The UPBEAT nurse-delivered personalized care intervention for people with coronary heart disease who report current chest pain and depression: a randomised controlled pilot study. | LitMetric
Health Services and Population Research Department, Institute of Psychiatry, King's College London, London, United Kingdom.
Published: August 2015
AI Article Synopsis
Article Abstract
Background: Depression is common in people with coronary heart disease (CHD) and associated with worse outcome. This study explored the acceptability and feasibility of procedures for a trial and for an intervention, including its potential costs, to inform a definitive randomized controlled trial (RCT) of a nurse-led personalised care intervention for primary care CHD patients with current chest pain and probable depression.
Methods: Multi-centre, outcome assessor-blinded, randomized parallel group study. CHD patients reporting chest pain and scoring 8 or more on the HADS were randomized to personalized care (PC) or treatment as usual (TAU) for 6 months and followed for 1 year. Primary outcome was acceptability and feasibility of procedures; secondary outcomes included mood, chest pain, functional status, well being and psychological process variables.
Result: 1001 people from 17 General Practice CHD registers in South London consented to be contacted; out of 126 who were potentially eligible, 81 (35% female, mean age = 65 SD11 years) were randomized. PC participants (n = 41) identified wide ranging problems to work on with nurse-case managers. Good acceptability and feasibility was indicated by low attrition (9%), high engagement and minimal nurse time used (mean/SD = 78/19 mins assessment, 125/91 mins telephone follow up). Both groups improved on all outcomes. The largest between group difference was in the proportion no longer reporting chest pain (PC 37% vs TAU 18%; mixed effects model OR 2.21 95% CI 0.69, 7.03). Some evidence was seen that self efficacy (mean scale increase of 2.5 vs 0.9) and illness perceptions (mean scale increase of 7.8 vs 2.5) had improved in PC vs TAU participants at 1 year. PC appeared to be more cost effective up to a QALY threshold of approximately £3,000.
Conclusions: Trial and intervention procedures appeared to be feasible and acceptable. PC allowed patients to work on unaddressed problems and appears cheaper than TAU.
Introduction: Proactive esophageal cooling reduces injury during radiofrequency (RF) ablation of the left atrium (LA) for the treatment of atrial fibrillation (AF). New catheters are capable of higher wattage settings up to 90 W (very high-power short duration, vHPSD) for 4s. Varying power and duration however does not eliminate the risk of thermal injury.
Schwannomas are peripheral nerve sheath tumors that rarely arise from autonomic nerves of the pleural lining. Most often, they present as slow-growing tumors and are asymptomatic. Herein, we describe the case of an elderly male patient who presented with severe chest pain.
Study Objectives: To evaluate the capability and accuracy of magnetocardiography (MCG) to identify patients with ischemic chest pain from those with non-ischemic pain and to verify normalcy in the MCG in healthy subjects.
Design: We studied 133 patients (mean age 59 ± 14 years, 69 % male) with chronic or acute chest pain syndrome and 63 healthy subjects (mean age 41.7 ± 12.
Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Background: Psychological disorders, such as anxiety and depression, are considered to be one of the causes of noncardiac chest pain (NCCP). And these patients can be challenging to differentiate from coronary artery disease (CAD), leading to a considerable number of patients still undergoing angiography. We aim to develop a practical prediction model and nomogram using cardiopulmonary exercise testing (CPET), to help identify these patients.
Introduction: Ischaemic heart disease (IHD) is a pathological process characterised by a blockage or non-obstructive accumulation of atherosclerotic plaques in the epicardial arteries. Percutaneous coronary intervention (PCI) is widely used in clinical practice to treat IHD. However, angina post PCI (APPCI) impairs quality of life and portends a worse prognosis.
