ISRCTN ISRCTN14711101
DOI https://doi.org/10.1186/ISRCTN14711101
Protocol serial number 11424
Sponsor Imperial College of Science, Technology and Medicine
Funder National Institute for Health Research
Submission date
04/03/2015
Registration date
05/03/2015
Last edited
05/07/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Chest pain is one of the most common reasons for attending an Accident & Emergency Department. Heart conditions often present with chest pain and many sufferers require emergency treatment to save their life. Most people who experience pain in the chest do not have any serious illness, but because of the potential fatal consequence of untreated heart disease, they are encouraged by medical professionals and publicly displayed advertisements, to seek help. Unfortunately there are very few services to deal with psychological causes of chest pain. Such patients are often inadequately managed, receiving a combination of support and reassurance that may reinforce rather than resolve the problem. A modification of cognitive behaviour therapy for chest pain (CBT-CP) has been developed. It is administered mainly by trained general nurses and preliminary results have shown it to work well. The aim of this study is to test its value formally.

Who can participate?
Patients aged between 16 and 75 with significant chest pain for which no significant disease explaining the condition has been found.

What does the study involve?
Participants are randomly allocated into one of two groups. Those in group 1 (intervention) are given between 4 and 10 sessions of CBT-CP treatment over a three month period. The treatment involves an initial assessment with a trained therapist followed by 3 to 9 further sessions of treatment each lasing about an hour, the number depending on the complexity and speed of response to treatment. Those in group 2 (control) are given the standard care offered by cardiology and other hospital clinics by general practitioners. Each patient is followed over a one year period and in which they undergo assessments of their anxiety levels, depression, amount of pain and discomfort experienced and general quality of life.

What are the possible benefits and risks of participating?
No adverse effects have been noted to date.

Where is the study run from?
Royal Berkshire Hospital, Kings Mill Hospital and the Hillingdon Hospital (UK)

When is the study starting and how long is it expected to run for?
July 2012 to March 2016.

Who is funding the study?
National Institute for Health Research (UK)

Who is the main contact?
1. Mrs Sylvia Cooper (public)
s.cooper@imperial.ac.uk
2. Professor Peter Tyrer (scientific)
p.tyrer@imperial.ac.uk

Contact information

Mrs Sylvia Cooper
Public

Centre for Mental Health
Imperial College
7th Floor
Commonwealth Building
Hammersmith Hospital
London
W12 0NN
United Kingdom

Phone +44 (0)207 386 1237
Email s.cooper@imperial.ac.uk
Dr Peter Tyrer
Scientific

Centre for Mental Health
Imperial College
7th Floor
Commonwealth Building
Hammersmith Hospital
London
W12 0NN
United Kingdom

ORCiD logoORCID ID 0000-0002-0358-1459
Phone +44 (0)208 383 4161
Email p.tyrer@imperial.ac.uk

Study information

Primary study designInterventional
Study designRandomised; Interventional; Design type: Treatment
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleRandomised controlled trial of modified cognitive behaviour therapy for non-cardiac chest pain
Study acronymCOPIC
Study objectivesDoes an adapted form of cognitive behaviour therapy for non-cardiac chest pain lead to reduced anxiety over health and lower health service costs than standard care over 6 months and one year.
Ethics approval(s)NRES Committee East Midlands - Northampton, 22/11/2011, ref: 11/EM/0376
Health condition(s) or problem(s) studiedTopic: Mental Health; Subtopic: Anxiety, Stress-related and somatoform; Disease: Anxiety, Stress-related and somatoform disorders
InterventionEqual (randomised) allocation of patients to:
1. Cognitive behaviour therapy arm, in which between 4 and 10 sessions of treatment are given by a supervised trained therapist over a three month period
2. Standard care given in cardiology and other hospital clinics, and by general practitioners

Follow Up Length: 12 month(s)
Intervention typeBehavioural
Primary outcome measure(s)

Change in scores on the Health Anxiety Inventory between baseline assessment and 6 months

Key secondary outcome measure(s)

1. Change in scores on the Health Anxiety Inventory between baseline assessment and 12 months
2. Change in scores on the Lucock Health Anxiety Questionnaire-Chest Pain version between baseline assessment and 6 months
3. Visual analogue scales for pain and discomfort between baseline assessment and 6 months
4. Schedule for Evaluating Persistent Symptoms (SEPS) between baseline assessment and 6 months
5. Hospital Anxiety and Depression Scale - Anxiety and Depression components between baseline assessment and 6 months
6. Quality of life (EQ-5D) between baseline assessment and 6 months
7. Social functioning (SFQ) between baseline assessment and 6 months
8. Costs using the Adult Service Use Schedule (AD-SUS) between baseline assessment and 6 months

Completion date31/03/2016

Eligibility

Participant type(s)Patient
Age groupAdult
SexAll
Target sample size at registration68
Key inclusion criteria1. Significant chest pain on at least two separate occasions in the past year in which no significant pathology explaining the symptoms was found
2. Signed consent to take part in the study
3. Aged between 16 and 75
Key exclusion criteriaPatients who are:
1. Under active psychiatric care
2. Have had a new prescription of a psychoactive drug within the previous two months
3. Receiving, or on waiting list for, a psychological treatment. Those who are currently stable and on regular psychoactive medication (for more than 2 months) are eligible for the study.
Date of first enrolment10/07/2012
Date of final enrolment31/01/2015

Locations

Countries of recruitment

  • United Kingdom
  • England

Study participating centres

Royal Berkshire Hospital
London Road
Reading
RG1 5AN
United Kingdom
Kings Mill Hospital
Mansfield Road
Sutton-in-Ashfield
Nottinghamshire
NG17 4JL
United Kingdom
The Hillingdon Hospital
Pield Heath Road
Uxbridge
UB8 3NN
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 16/05/2017 Yes No
Protocol article protocol 24/11/2015 Yes No
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

05/07/2017: Publication reference added.