Imperial College London

Emeritus ProfessorPeterTyrer

Faculty of MedicineDepartment of Brain Sciences

Emeritus Professor in Community Psychiatry - Clinical



+44 (0)20 3313 4161p.tyrer




13.09Claybrook CentreCharing Cross Campus






BibTex format

author = {Tyrer, P and Tyrer, H and Morris, R and Crawford, MJ and Cooper, S and Yang, M and Guo, B and Mulder, R and Kemp, S and Barrett, B},
doi = {10.1136/openhrt-2016-000582},
journal = {Open Heart},
title = {Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: multicentre, randomised controlled trial},
url = {},
volume = {4},
year = {2017}

RIS format (EndNote, RefMan)

AB - Background: Non-cardiac chest pain is very common and generally managed inappropriately. Psychological interventions need more attention.Methods: We tested the effectiveness and cost-effectiveness of a modified form of cognitive behaviour therapy for chest pain (CBT-CP)(4-10 sessions) in patients who attended cardiology clinics or emergency medical services repeatedly. We planned to recruit 96 patients. Participants were randomised using a remote web-based system to CBT-CP or to standard care in the clinic. Assessments were made at baseline and at six and 12 months. The primary outcome was the change in the Health Anxiety Inventory score at six months. Other clinical measures, social functioning, quality of life, and costs of services were also recorded. Findings: 68 patients were randomised with low attrition rates at 6 and 12 months with 81% of all possible assessments completed at 6 and 12 months. Many more patients who were eligible were not referred. The Although there were no significant group differences between any of the outcome measures at either 6 or 12 months, patients receiving CBT-CP had between two and three times fewer hospital bed days, outpatient appointments, and A&E attendances than those allocated to standard care and total costs per patient were £1496.49 lower, though the differences in costs were not significant. There was a small non- significant gain in quality adjusted life years (QALY's) in those allocated to CBT-CP compared with standard care (0.76 vs 0.74). Interpretation: It is concluded that CBT-CP in the context of current hospital structures is not a feasible or viable treatment, but is worthy of further research as a potentially cost-effective treatment for non-cardiac chest pain.
AU - Tyrer,P
AU - Tyrer,H
AU - Morris,R
AU - Crawford,MJ
AU - Cooper,S
AU - Yang,M
AU - Guo,B
AU - Mulder,R
AU - Kemp,S
AU - Barrett,B
DO - 10.1136/openhrt-2016-000582
PY - 2017///
SN - 2053-3624
TI - Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: multicentre, randomised controlled trial
T2 - Open Heart
UR -
UR -
VL - 4
ER -