The Mindfulness in Pain in the Chest (MIPIC) is a research study exploring the use of mindfulness therapy in patients with stable chest pain where the pain has not been found to be arising from the heart.
What is the reason for the study?
Pain in the chest is a common symptom for which patients go to their GPs (general practitioners). After initial assessment, if the GP think that the pain may be coming from the heart, they refer the patient to the chest pain clinic in a nearest hospital. The patients undergo further assessment in the hospital with different tests and less than 10% of patients are found to have the pain arising from the heart itself.
In other patients the chest pain may be caused by acid reflux or be of musculo-skeletal origin. However, in almost 75% of patients no cause for the pain is identified. In some of these patients the pain may resolve spontaneously while in others it may persist for long time. The pain can result in individual suffering, difficulty in performing daily activities and work, and frequent visit to doctors.
The purpose of this study is to explore alternative ways to manage chest pain. One of these ways is ‘mindfulness’, which involves training the mind to be in the present moment with openness, curiosity, and acceptance. It enhances the awareness of one’s external surroundings and inner sensations, allowing the individual to step back, and manage difficult experiences differently, understanding what might be most helpful for well-being.
Mindfulness has been used to reduce longstanding pain from any cause when pain persists despite trying all recommended medical treatment(s). It has also been used for managing stress, pain in fibromyalgia, irritable bowel syndrome, and to prevent recurrent depression. However, there has been no study to evaluate the value of mindfulness in those suffering from chest pain.
More information about mindfulness can be found from lectures by pioneers like Professor Jon Kabat Zinn, Professor Mark Williams, who developed mindfulness based cognitive therapy, and Professor Shauna Shapiro’s journey with her own pain and mindfulness.
Who can take part?
We are currently recruiting patients who have attended the chest pain clinic at Harefield Hospital in 2019 and have persistent chest pain despite excluding its origin from the heart or treatment from other conditions.
What does the study involve?
The mindfulness programme to be used for this study is based on well recognised MBCT (Mindfulness Based Cognitive Therapy) course developed by Prof Mark Williams and colleagues in UK and Canada. It will involve attending 2-hour classes at Harefield Hospital over a duration of 8-weeks with a 6-hour practice on the 6th weekend. The classes are held in groups of up to 15 people and will be delivered by experienced mindfulness teachers. The group sessions are structured including meditation practices in sitting position (on a chair), lying position, yoga and other stretching exercises, walking, and group discussions.
In view of the COVID-19 pandemic, if there is a continuing requirement for social distancing with a 2-metre gap between participants, the classes will be held virtually over a secure video conference/ meeting platform in a format similar to the standard course with the teacher guiding the meditation practices and discussion.
Between the classes, you will be asked to practice at home for about 45-minutes each day and do some other tasks (e.g. keep a diary).
For more details of the study, please download the participant information sheet.
How to get involved
If you have persistent chest pain and fulfil the criteria in section ‘who can take part’ or simply wish to know more about the study, please contact us be email or telephone.
Contact us to find out more
Study contact: Paula Rogers, Claire Prendergast
Contact phone number: 01895 823737, bleep 6085 or 6429
Chief investigator: Dr Tarun K Mittal
Chief investigator email: mipic@rbht.nhs.uk
Research Project Information
Speciality category: Heart disease
Research Title: Mindfulness based intervention in patients with persistent pain in chest (MIPIC) of non-cardiac cause - a feasibility randomised control study
Research Ethics Committee: London- Riverside Research Ethics Committee (19/LO/1092)
IRAS number: 253106