A randomized controlled trial of a brief educational and psychological intervention for patients presenting to a cardiac clinic with palpitation.
BACKGROUND
We sought to determine whether a brief psycho-educational intervention reduced disability in patients with benign palpitation.


METHODS
In a pragmatic randomized controlled trial within a cardiology clinic at a district general hospital, 80 consecutive patients diagnosed as having benign palpitation--either palpitation due to awareness of extrasystoles or sinus rhythm--with associated distress or disability were randomized to an intervention group (usual care plus nurse-delivered intervention based on cognitive-behavioural principles) or to a control group (usual care). Principal outcome was difference in proportion of participants with good or excellent researcher-rated activity levels at 3 months. Subsidiary outcomes were self-rated symptoms, distress and disability, researcher-rated unmet treatment needs.


RESULTS
The principal outcome showed a statistically and clinically significant benefit for the intervention group, with a number needed to treat of 3 (95% CIs 2 to 7). All but one subsidiary outcomes also showed a difference in favour of the intervention group, and several differences reached statistical significance. Significantly more of the control group had unmet treatment needs at 3 months.


CONCLUSIONS
A brief, nurse-delivered, psycho-educational intervention, was an effective treatment for benign palpitation. Further evaluation, including assessment of cost-effectiveness, is needed. The findings have application to the care of patients presenting with other types of 'unexplained' medical symptoms.
Mayou
R
R
University of Oxford Department of Psychiatry, Warneford Hospital, Oxford.
Sprigings
D
D
Birkhead
J
J
Price
J
J
D000328:Adult; D005117:Cardiac Complexes, Premature / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009449:Neurocirculatory Asthenia / Q000523:psychology / Q000628:therapy*; D010348:Patient Care Team; D010353:Patient Education as Topic; D011614:Psychotherapy, Brief; D012803:Sick Role; D016896:Treatment Outcome