Online Therapy Reduced Anxiety in Chest Pain Patients
A clinical trial found that peer-supported cognitive behavioral therapy lowers anxiety for low-risk emergency room patients.
Updated on Sept. 30, 2026 in Heart Disease
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A recent study found that peer-supported online cognitive behavioral therapy effectively reduces anxiety in adult emergency room patients who present with low-risk chest pain. Researchers discovered that many patients visiting the ER for chest pain are actually dealing with anxiety or panic disorders rather than heart-related issues.
Why it matters
The findings offer a potential solution to reduce the burden on emergency departments by providing targeted mental health support to patients whose physical chest pain symptoms are not linked to heart disease. This approach could lower the demand for therapist time while improving patient outcomes.
The study enrolled 375 adults with HEART risk scores below 7 and GAD-7 anxiety scores of at least 8. The intervention involved an online cognitive behavioral therapy program spanning eight to 12 weeks.
The players
Patient-Centered Outcomes Research Institute
This organization funded the research trial with a $3.4 million contract.
Indiana University School of Medicine
Researchers based in Indianapolis conducted the clinical trial.
Wayne State University
Academic researchers based in Detroit contributed to the study design and analysis.
The details
Participants were randomly assigned to primary care referral, therapist-led cognitive behavioral therapy, or the peer-supported online version. The online course consisted of six individual lessons, which reduces the total time commitment required from clinical therapists.
Timeline
July 2024: Trial enrollment concluded.
September 28, 2026: The study results were published in JAMA Internal Medicine.
The Big Picture
This study updates the findings of the PACER trial by identifying specific digital interventions for anxiety management. It follows a pattern set by research aimed at diverting non-cardiac chest pain cases from emergency departments to more appropriate care settings.
Patients who regularly visit emergency rooms for chest pain may eventually receive access to online therapy as an alternative to traditional counseling. This could allow individuals to manage anxiety symptoms more conveniently through a remote, peer-supported format.
The takeaway
Healthcare providers may soon shift toward screening chest pain patients for anxiety to provide faster, specialized mental health support. Integrating digital tools can help patients address underlying psychological causes of their symptoms while reducing reliance on emergency services.
Further reading
For more information on cardiovascular health research, visit our Heart Disease section.
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Would you trust an online therapy program to manage your anxiety symptoms?
