What is it about?
One in three heart patients experience symptoms of anxiety and depression. Psychological help is not routinely available and has been shown to be of limited help to this group. A new talking-based therapy called metacognitive therapy (MCT for short) has been found to be helpful when delivered in a group, but not everyone can attend clinic-based treatment. We wanted to see if it is possible to run a clinical trial of a home-based self-help MCT and see what patients think of this therapy. 108 heart patients with high anxiety and/or depression were recruited and randomly assigned to either usual cardiac rehabilitation (CR) or usual CR plus self-help MCT. To assess whether this is achievable and acceptable we looked at: (1) ratings of what patients thought about the treatment, (2) rates of recruitment, (3) how many patients dropped out, and (4) the number of self-help modules patients completed. We also used scores on anxiety and depression symptom measures to estimate how many patients we would need for a larger study to test the effectiveness of self-help MCT. Self-help MCT was found to be achievable and acceptable for this group of patients. Recruitment and retention of participants was high, and adding self-help MCT to CR did not impact on patient attendance at usual CR. Patients found self-help MCT easy to use and understand. Completion was high, however the patients rated the quality of the telephone support calls lower than expected. The study results supported doing a large-scale trial. Self-help MCT could provide new and accessible treatment options for cardiac patients with anxiety and depression.
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Why is it important?
Our findings show that it is possible to conduct a home-based trial of self-help metacognitive therapy in heart patients. The results supported transition to a full-scale randomised trial for anxiety and depression.
Perspectives
Working with clinical, academic and service user colleagues on this project has been enlightening and a real pleasure. The study has allowed us to transition to a full-scale trial of self-help metacognitive therapy which has had a significant positive impact.
Dr Adrian Wells
University of Manchester
Read the Original
This page is a summary of: Metacognitive therapy self-help for anxiety-depression: Single-blind randomized feasibility trial in cardiovascular disease., Health Psychology, May 2022, American Psychological Association (APA),
DOI: 10.1037/hea0001168.
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