BBC East Midlands Today report on CBT for “health anxiety MUS

short report on local news tonight promoting the MUS/psychology agenda

Local news is only on Iplayer for 24 hours and not downloadable I will email them asking for a transcript.

A woman was shown who feels she benefited from a short course of CBT. She talks about going undiagnosed for several years having to have different tests and not being believed. Then she was diagnosed with fibro 3 years ago. Ostensibly “health anxiety” looking at the internet a lot was a continuing issue despite the diagnosis. Professor Richard Morriss of Institute of Mental Health in Nottingham talks about CBT by video 6-12 sessions helping people address anxiety catastrophising highlighted people thinking they might have cancer or a heart attack. Reporter talks about a “vicious cycle of false illness beliefs thoughts feelings and actions”.

Reporter also says “Effective treatment according to the experts in Nottingham could save a fortune”

156 patients with health anxiety given CBT 12 months on 62% don’t have health anxiety presumably a study found this press release from the university funded by NIHR https://www.nottingham.ac.uk/news/p...alth-anxiety-and-saves-money-study-finds.aspx

 

The paper referenced in the article is here

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1253-5

Clinical and economic outcomes of remotely delivered cognitive behaviour therapy versus treatment as usual for repeat unscheduled care users with severe health anxiety: a multicentre randomised controlled trial

• Richard MorrissView ORCID ID profile,
• Shireen Patel,
• Sam Malins,
• Boliang Guo,
• Fred Higton,
• Marilyn James,
• Mengjun Wu,
• Paula Brown,
• Naomi Boycott,
• Catherine Kaylor-Hughes,
• Martin Morris,
• Emma Rowley,
• Jayne Simpson,
• David Smart,
• Michelle Stubley,
• Joe Kai and
• Helen Tyrer

Abstract

Background
It is challenging to engage repeat users of unscheduled healthcare with severe health anxiety in psychological help and high service costs are incurred. We investigated whether clinical and economic outcomes were improved by offering remote cognitive behaviour therapy (RCBT) using videoconferencing or telephone compared to treatment as usual (TAU).

Methods
A single-blind, parallel group, multicentre randomised controlled trial was undertaken in primary and general hospital care. Participants were aged ≥18 years with ≥2 unscheduled healthcare contacts within 12 months and scored >18 on the Health Anxiety Inventory. Randomisation to RCBT or TAU was stratified by site, with allocation conveyed to a trial administrator, research assessors masked to outcome. Data were collected at baseline, 3, 6, 9 and 12 months. The primary outcome was change in HAI score from baseline to six months on an intention-to-treat basis. Secondary outcomes were generalised anxiety, depression, physical symptoms, function and overall health. Health economics analysis was conducted from a health service and societal perspective.

Results
Of the 524 patients who were referred and assessed for trial eligibility, 470 were eligible and 156 (33%) were recruited; 78 were randomised to TAU and 78 to RCBT. Compared to TAU, RCBT significantly reduced health anxiety at six months, maintained to 9 and 12 months (mean change difference HAI –2.81; 95% CI –5.11 to –0.50; P = 0.017). Generalised anxiety, depression and overall health was significantly improved at 12 months, but there was no significant change in physical symptoms or function. RCBT was strictly dominant with a net monetary benefit of £3,164 per participant at a willingness to pay threshold of £30,000. No treatment-related adverse events were reported in either group.

Conclusions
RCBT may reduce health anxiety, general anxiety and depression and improve overall health, with considerable reductions in health and informal care costs in repeat users of unscheduled care with severe health anxiety who have previously been difficult to engage in psychological treatment. RCBT may be an easy-to-implement intervention to improve clinical outcome and save costs in one group of repeat users of unscheduled care.

 

So another open label trial with subjective outcomes being hyped in the press.

The press story didn't report "there was no significant change in physical symptoms or function."

 

Absolutely did not all about reducing health anxiety and saving money didn’t specify that was from fewer GP visits but.......

 

https://twitter.com/user/status/1091286910964772864

 

No mention of ME the patient who was interviewed has a Fibromyalgia diagnosis