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Health anxiety and medically unexplained symptoms cost the National
Health Service (NHS) an estimated £3 billion per year in unnecessary
costs with little evidence of patient benefit. Effective treatment is
rarely taken up due to issues such as stigma or previous negative
experiences with mental health services. An approach to overcome this
might be to offer remotely delivered psychological therapy, which can be
just as effective as face-to-face therapy and may be more accessible and
To investigate the clinical outcomes and cost-effectiveness of remotely
delivered cognitive–behavioural therapy (CBT) to people with high health
anxiety repeatedly accessing unscheduled care (trial registration:
A multicentre randomised controlled trial (RCT) will be undertaken in
primary and secondary care providers of unscheduled care across the East
Midlands. One hundred and forty-four eligible participants will be
equally randomised to receive either remote CBT (6–12 sessions) or
treatment as usual (TAU). Two doctoral research studies will investigate
the barriers and facilitators to delivering the intervention and the
factors contributing to the optimisation of therapeutic outcome.
This trial will be the first to test the clinical outcomes and
cost-effectiveness of remotely delivered CBT for the treatment of high
The findings will enable an understanding as to how this intervention
might fit into a wider care pathway to enhance patient experience of
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