Cognitive behavioural intervention for adults with anxiety complications of asthma: prospective randomised trial.
BACKGROUND
High levels of asthma-related fear and panic exacerbate asthma symptoms and complicate the management of asthma. Asthma-specific fear may be reduced by a cognitive behavioural intervention. We aimed to test if there is a reduction in asthma-specific fear after cognitive behavioural intervention compared with routine treatment.


METHODS
Adults with asthma registered with family doctors in Sheffield UK were screened for anxiety and 94 highly anxious patients were randomly allocated to receive either a cognitive behavioural intervention to improve self-management of their anxiety (n = 50) or routine clinical care (n = 44). Asthma-specific fear at the end of treatment and at six month follow up were the primary endpoints. Service usage in the six months prior to and six months following the intervention was monitored to allow estimation of costs. Data were analysed by intention to treat.


FINDINGS
At the end of treatment, there was a significantly greater reduction in asthma-specific fear for people in the CBT group compared with controls. At six months after treatment the reduction in asthma-specific fear in the CBT group was increased and the difference between treatment and control group was statistically significant. Service use costs were not reduced in the CBT group.


INTERPRETATION
A brief cognitive behavioural intervention was found to have efficacy in reducing asthma-specific panic fear immediately after treatment and at 6 months follow up. There was no cost advantage to cognitive behavioural treatment.