BMJ  2008;336:338-339 (16 February), doi:10.1136/bmj.39465.522569.80

Editorials

Self management training in refractory angina

May improve health related quality of life and cut treatment costs

The first 150 words of the full text of this article appear below.

Refractory angina pectoris is a major clinical problem characterised by unremitting symptoms of angina (equivalent to severity score class III-IV on the Canadian Cardiovascular Society classification), which are resistant to conventional treatments including nitrates, calcium channel and β adrenoceptor blockade, percutaneous coronary interventions, and coronary artery bypass grafting.¹ Although there are limitations in current surveillance systems worldwide, estimates from data on revascularisation and hospital admission suggest a prevalence of refractory angina somewhere between 600 000 and 1.8 million in the United States and an incidence of 30-50 000/year in continental Europe.^{1 2}

Patients with refractory angina experience persistent anginal pain, poor general health status, psychological distress, restriction of activity, and inability to self manage their symptoms—all of which have a negative effect on health related quality of life.^{1 2}

Self management training that includes cognitive behaviour techniques is showing promise in angina.^{3 4} Indeed, it could be a welcome standard addition to the . . . [Full text of this article]

¹ McMaster University, Faculty of Health Sciences, HSC 2J20A, Hamilton, ON L8N 3Z5 Canada , ² Multidisciplinary Pain Centre, Sahlgrenska University Hospital/Östra, 416 85 Göteborg, Sweden, ³ Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8 Canada

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Cognitive behavioural interventions work in chronic refractory angina

Professor Michael R Chester, et al.
bmj.com, 24 Feb 2008 [Full text]