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Mindfulness-based intervention in patients with persistent pain in chest (MIPIC) of non-cardiac cause: a feasibility randomised control study

  • Mittal, Tarun Kumar1, 2
  • Evans, Emma3
  • Pottle, Alison1
  • Lambropoulos, Costas4
  • Morris, Charlotte4
  • Surawy, Christina5
  • Chuter, Antony1
  • Cox, Felicia1
  • de Silva, Ranil1, 2
  • Mason, Mark1, 2
  • Banya, Winston6
  • Thakrar, Diviash7
  • Tyrer, Peter2
  • 1 Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK , London
  • 2 Imperial College London, London, UK , London
  • 3 Oxford University Hospitals NHS Foundation Trust, Oxford, UK , Oxford
  • 4 Paron Mindfulness, London, UK , London
  • 5 Oxford Mindfulness Centre, Department of Psychiatry, University of Oxford, Oxford, UK , Oxford
  • 6 Royal Brompton and Harefield Hospitals, London, UK , London
  • 7 Acre Surgery, London, UK , London
Published Article
Open Heart
Publication Date
May 11, 2022
DOI: 10.1136/openhrt-2022-001970
PMID: 35545356
PMCID: PMC9096570
PubMed Central
  • 1506


Objective The study evaluated the feasibility of mindfulness-based cognitive therapy (MBCT) in patients with non-cardiac chest pain by assessing their willingness to participate and adhere to the programme, and for these data to help further refine the content of MBCT for chest pain. Patients and methods This prospective 2:1 randomised controlled trial compared the intervention of adapted MBCT as an addition to usual care with just usual care in controls. Among 573 patients who attended the rapid access chest pain clinic over the previous 12 months and were not diagnosed with a cardiac cause but had persistent chest pain were invited. The intervention was a 2-hour, weekly, online guided 8-week MBCT course. Compliance with attendance and the home practice was recorded. Enrolled patients completed the Seattle angina questionnaire (SAQ), Hospital Anxiety and Depression Scale, Cardiac Anxiety Questionnaire, Five-Facet Mindfulness Questionnaire, and Euro Quality of Life–5 Dimensions–5 Level at baseline assessment and after 8-week period. Results Persistent chest pain was reported by 114 patients. Of these, 33 (29%) patients with a mean age of 54.2 (±12.2) years and 68% women, consented to the study. Baseline questionnaires revealed mild physical limitation (mean SAQ, 76.8±25), high levels of anxiety (76%) and depression (53%), modest cardiac anxiety (CAQ,1.78±0.61) and mindfulness score (FFMQ, 45.5±7.3). Six patients subsequently withdrew due to bereavement, caring responsibilities and ill health. Of the remaining 27 participants, 18 in the intervention arm attended an average of 5 sessions with 61% attending ≥6 sessions. Although not statistically powered, the study revealed a significant reduction in general anxiety, improved mindfulness and a trend towards improvement in SAQ scores in the intervention arm. Conclusion One-third of patients with persistent non-cardiac chest pain were willing to participate in mindfulness-based therapy. An improvement in anxiety and mindfulness was detected in this feasibility study. A larger trial is required to demonstrate improvement in chest pain symptoms.

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