MCT PATHWAY

MCT PATHWAY

MCT Pathway

Cardiac rehabilitation 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. Around a third (37%) of patients accessing cardiac rehabilitation services experience significant anxiety and/or depressive symptoms. Distress reduces quality of life and increases the risk of death, further cardiac events and increases healthcare use. Available drug and psychological treatments have only small effects on distress and quality of life, and no effects on physical health in cardiac rehabilitation patient populations. Therefore, it is essential that more effective treatments for depression and anxiety are integrated into cardiac rehabilitation services.

Aims of the study

Study design

A single-blind randomised controlled trial with a four month and 12 month follow up comparing Group-Metacognitive Therapy plus usual CR (intervention group) with usual CR alone (control group). The study took place at five NHS sites in the North West. First, we ran a pilot trial of the Group-Metacognitive Therapy intervention with 50 heart disease patients experiencing distress following a cardiac event. This was followed by a full-scale randomised controlled trial (RCT) with 332 heart disease patients also experiencing distress following a recent cardiac event.

Further information

More information about our study can also be found at: clinicaltrials.gov UK Clinical Research Network Study Portfolio

Patient and Public Involvement and Pathway

Hear from two of our PPI members about their experience joining PATHWAY

PATHWAY is funded by the National Institute for Health Research (NIHR).

This website presents independent research funded by the National Institute for Health Research under its Program Grants for Applied Research Program (grant No. RP-PG-1211-20011). The views expressed are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health.

WHAT IS GROUP METACOGNITIVE THERAPY (MCT)?

Metacognitive Therapy was developed by Professor Adrian Wells. It directly reduces worry, rumination and unhelpful thinking styles and modifies the specific beliefs behind them. It is a psychological treatment that helps people to manage worries and low mood through reducing unhelpful styles of thinking and has been shown to alleviate depression and anxiety in mental health settings. Extensive evidence shows that a particular style of thinking dominated by rumination (dwelling on the past) and worry (concerns about the future) maintains emotional distress. Metacognitive therapy helps people to discover new and more helpful ways to react to negative or distressing thoughts, so they are less likely to dwell on them, resulting in a positive effect on anxiety and mood. As part of the PATHWAY trial, we delivered metacognitive therapy in a group of 3-10 patients. Patients received six sessions that lasted 60 minutes. Sessions were delivered by a trained health professional from cardiac rehabilitation services, this includes nurses, physiotherapists, and occupational therapists.

Watch Our PATHWAY Results Discussion

IS METACOGNITIVE THERAPY EFFECTIVE AT REDUCING ANXIETY/DEPRESSION IN CARDIAC PATIENTS?

Yes, it is! Watch our video to find out more about how group-MCT is effective at treating anxiety and depression in cardiac rehabilitation patients

PATHWAY Q&A

PATHWAY is funded by the National Institute for Health Research (NIHR). This website presents independent research funded by the National Institute for Health Research under its Program Grants for Applied Research Program (grant No. RP-PG-1211-20011). The views expressed are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health.

WHAT IS HOME-BASED METACOGNITIVE THERAPY (MCT)?

This is metacognitive therapy delivered in a home-based format. The home-based metacognitive format includes: A Home-MCT Booklet (6 modules), The SPACE CD, 3 telephone support calls delivered by a trained healthcare professional. The Home-MCT booklet focuses on modifying the metacognitive beliefs and processes that maintain distress (e.g., anxiety, low mood). The modules are designed to work through at your own pace, but we estimate that one module per week should be completed. Modules include well-specified techniques for developing new strategies to overcome worry and rumination and modifying the beliefs that maintain unhelpful patterns of thinking. Telephone support calls are delivered throughout and offer support and guidance on completing the modules and using the Home-MCT techniques. The telephone calls are delivered by a trained healthcare professional. PATHWAY is funded by the National Institute for Health Research (NIHR). PATHWAY is funded by the National Institute for Health Research (NIHR).

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