A Brief Cognitive-Behavioral Intervention Reduces Hospital Admissions in Refractory Angina Patients

Moore, Roger K.; Groves, David G.; Bridson, John D; Grayson, Antony D.; Wong, Helen; Leach, Austin; Lewin, Robert; Chester, Michael R.

doi:10.1016/j.jpainsymman.2006.10.009

Cited by 38 publications

(19 citation statements)

References 13 publications

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“…In cases of refractory angina, a programme of education and self-management using an outpatient cognitive-behavioural programme has been successful in reducing angina symptoms. Patients attending the programme showed significant improvement on measures of angina frequency and stability, quality of life, anxiety and depression [131]; as well as a reduction in hospital visits, and a reduction in healthcare costs [132].…”

Section: Cognitive-behavioural Therapy (Cbt)mentioning

confidence: 99%

An overview of treatment approaches for chronic pain management

2016

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Pain which persists after healing is expected to have taken place, or which exists in the absence of tissue damage, is termed chronic pain. By definition chronic pain cannot be treated and cured in the conventional biomedical sense; rather, the patient who is suffering from the pain must be given the tools with which their long-term pain can be managed to an acceptable level. This article will provide an overview of treatment approaches available for the management of persistent non-malignant pain. As well as attempting to provide relief from the physical aspects of pain through the judicious use of analgesics, interventions, stimulations, and irritations, it is important to pay equal attention to the psychosocial complaints which almost always accompany long-term pain. The pain clinic offers a biopsychosocial approach to treatment with the multidisciplinary pain management programme; encouraging patients to take control of their pain problem and lead a fulfilling life in spite of the pain.

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Section: Cognitive-behavioural Therapy (Cbt)mentioning

confidence: 99%

An overview of treatment approaches for chronic pain management

2016

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“…8 Additional approaches, such as cognitive behavioral therapy programs, may also be effective. 13 A considerable number of therapeutic modalities for the treatment of Alternative approaches aimed at achieving therapeutic angiogenesis through gene or progenitor cell therapy remain under active investigation,a 33-36 but are not considered part of a routine therapy.…”

Section: Treatment Optionsmentioning

confidence: 99%

Narrowing of the Coronary Sinus

Konigstein

Verheye

Jolicœur

et al. 2016

Cardiology in Review

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Alongside the remarkable advances in medical and invasive therapies for the treatment of ischemic heart disease, an increasing number of patients with advanced coronary artery disease unsuitable for revascularization continue to suffer from angina pectoris despite optimal medical therapy. Patients with chronic angina have poor quality of life and increased levels of anxiety and depression. A considerable number of innovative therapeutic modalities for the treatment of chronic angina have been investigated over the years; however, none of these therapeutic options has become a standard of care, and none are widely utilized. Current treatment options for refractory angina focus on medical therapy and secondary risk factor modification. Interventions to create increased pressure in the coronary sinus may alleviate myocardial ischemia by forcing redistribution of coronary blood flow from the less ischemic subepicardium to the more ischemic subendocardium, thus relieving symptoms of ischemia. Percutaneous, transvenous implantation of a balloon expandable, hourglass-shaped, stainless steel mesh in the coronary sinus to create a fixed focal narrowing and to increase backwards pressure, may serve as a new device-based therapy destined for the treatment of refractory angina pectoris.

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“…Understanding of common thinking errors and behaviours associated with chronic physical symptoms has led to the development of effective cognitive-behavioural therapy (CBT) for all the symptoms discussed here:  Non-malignant pain (Glombiewski et al, 2010)  Chest pain in people with diagnosed CHD (Lewin et al, 2002)  Chronic stable angina (Moore et al, 2007)  Non-cardiac chest pain (Kisely et al, 2012)  Palpitations (Jonsbu et al, 2010)  Breathlessness (Coventry and Gellatly, 2008;Howard and Dupont, 2014)  Fatigue (White et al, 2011) Protocols for specific symptoms vary, but the CBT approach is to challenge misconceptions that all symptoms are bad and should be avoided. CBT therapists use education, behavioural experiments (helping the patient to test the effect of activity) and opportunities to experience symptoms in a safe "The damage to my heart is permanent"…”

Section: Symptom Managementmentioning

confidence: 99%

Using health psychology techniques to manage chronic physical symptoms

Barley

Lawson

2016

Br J Nurs

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Chest pain and palpitations, non-malignant pain, breathlessness and fatigue often endure despite the receipt of appropriate nursing and medical care. This is distressing for patients, impacts on their quality of life and ability to function and is associated with high healthcare usage and costs. The cognitive behavioural approach offers nurses a model to understand how people's perceptions and beliefs and their emotional, behavioural and physiological reactions are linked. Common 'thinking errors' which can exacerbate symptom severity and impact are highlighted. Understanding of this model may help nurses to help patients cope better with their symptoms by helping them to come up with alternative more helpful beliefs and practices. Many Improving Access to Psychological Therapy services offer support to people with chronic physical symptoms and nurses are encouraged to sign post patients to them.In this article, the authors discuss how health psychology can help nurses to help patients to manage physical symptoms which have become chronic. That is those symptoms which continue despite the patient receiving appropriate nursing and medical care. Effective management of chronic symptoms is important for the NHS since patients with such symptoms incur high healthcare costs often through frequent but avoidable use of primary and emergency care (Celano et al, 2016;Kohlmann, Gierk, Hilbert, Brähler and Löwe, 2016;Kroenke, 2014;McDaid and Park, 2015). Nurses in a variety of fields will encounter patients with chronic physical symptoms. Among the most common are nonmalignant pain, acute chest pain and palpitations, breathlessness and fatigue. These symptoms, the scale of the problem and their impact is summarized briefly below. We then discuss the dominant health psychology model for understanding chronic symptoms -the cognitive behavioural model.

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A Brief Cognitive-Behavioral Intervention Reduces Hospital Admissions in Refractory Angina Patients

Cited by 38 publications

References 13 publications

An overview of treatment approaches for chronic pain management

An overview of treatment approaches for chronic pain management

Narrowing of the Coronary Sinus

Using health psychology techniques to manage chronic physical symptoms

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