WS3-PATHWAY-HOME-MCT (RP-PG-1211-20011)
Research type
Research Study
Full title
A feasibility study on integrating home-based metacognitive therapy for anxiety and depression in the cardiac rehabilitation pathway (PATHWAY STUDY 3).
IRAS ID
186990
Contact name
Adrian Wells
Contact email
Sponsor organisation
Greater Manchester Mental Health NHS Foundation Trust
Duration of Study in the UK
2 years, 9 months, 29 days
Research summary
Cardiac rehabilitation (CR) services aim to improve heart disease patients’ health and quality of life, and reduce the risk of further cardiac events. Approximately 69,000 patients attend cardiac rehabilitation annually in the UK across 372 programmes. Depression and anxiety (distress) are common among cardiac rehabilitation patients: 37% of patients have significant anxiety and/or depressive symptoms. Distressed patients are at greater risk of death, further cardiac events and poorer quality of life than those without distress and use more healthcare resources, leading to greater NHS costs. Available drug and psychological treatments have only small effects on distress and quality of life, and no effects on physical health. Furthermore, the needs of heart disease patients who have depression and anxiety are not being met by the NHS despite the treatment of distress being emphasised in key NHS policy. Therefore, it is essential that more effective treatments for depression and anxiety are integrated into cardiac rehabilitation services.\n\nExtensive evidence shows that a style of thinking dominated by rumination (dwelling on the past) and worry maintains emotional distress. Research has shown that Metacognitive Therapy (MCT), a psychological intervention, reduces this style of thinking, alleviating depression and anxiety in mental health settings. The PATHWAY programme aims to integrate two versions of this intervention into cardiac rehabilitation services: a group intervention and a home-based intervention. This will provide choice to patients and is consistent with NHS policy which recommends a ‘menu-based’ approach to widen uptake and participation in cardiac rehabilitation. The programme will lead to better informed and integrated care with the potential to improve psychological and physical well-being as well as reduce NHS costs. \n\nThe evaluation of group metacognitive therapy (Group-MCT) is detailed in a separate IRAS submission (15/NW/0163). In the current study, we will evaluate the feasibility and acceptability of integrating home-based metacognitive therapy (Home-MCT) into cardiac rehabilitation services in a single blind feasibility randomised controlled trial.[COVID-19 amendment – 09/04/2020] The amendment is to conduct further follow-up questionnaires to assess how patients are dealing with the Covid-19 pandemic. This will allow the applicants to see if MCT had any long-term effects.
REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
16/NW/0786
Date of REC Opinion
11 Nov 2016
REC opinion
Favourable Opinion