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Cited by 16Cardiac Health and Mental HealthAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and Assessments

Evaluating metacognitive therapy to improve treatment of anxiety and depression in cardiovascular disease: the NIHR funded PATHWAY research Programme

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Wells, Adrian, Reeves, David, Heal, Calvin, Davies, Linda M., Shields, Gemma E., Heagerty, Anthony, Fisher, Peter, Doherty, Patrick +1 more·2022·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2022.886407PMC PMC9204153
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Abstract

Background Anxiety and depression contribute to poorer physical and mental health outcomes in cardiac patients. Psychological treatments are not routinely offered in cardiac care and have mixed and small effects. We conducted a series of studies under the PATHWAY research programme aimed at understanding and improving mental health outcomes for patients undergoing cardiac rehabilitation (CR) through provision of metacognitive therapy (MCT). Methods PATHWAY was a series of feasibility trials, single-blind, multicenter, randomized controlled trials (RCTs), qualitative, stated preferences for therapy and health economics studies. Findings Patients felt their psychological needs were not met in CR and their narratives of distress could be parsimoniously explained by the metacognitive model. Patients reported they would prefer therapy over no therapy as part of CR, which included delivery by a cardiac professional. Two feasibility studies demonstrated that RCTs of group-based and self-help MCT were acceptable, could be embedded in CR services, and that RCTs of these interventions were feasible. A definitive RCT of group-MCT within CR (n = 332) demonstrated significantly greater reductions in the severity of anxiety and depression, exceeding CR alone, with gains maintained at 12 month follow-up (SMD HADS total score = 0.52 at 4 months and 0.33 at 12 months). A definitive trial of self-help MCT is ongoing. Conclusion There is a need to better meet the psychological needs of CR patients. Embedding MCT into CR demonstrated high acceptability and improved efficacy on psychological outcomes. Results support roll-out of MCT in CR with evaluation of national implementation. Registration URL: NCT02420431; ISRCTN74643496; NCT03129282.

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  • The effect of MCT on CVD patients has been investigated and demonstrated in several studies.

    “The effect of MCT on CVD patients has been investigated and demonstrated in several studies (15).”

    From Improving mental well-being in psychocardiology—a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients (2023) · cites this paper as [15]

    The Full-Scale Trial section reports that adding group MCT to cardiac rehabilitation significantly improved anxiety and depression outcomes. The paper also describes two feasibility studies, but its Findings section says those demonstrated acceptability and trial feasibility, not clinical effects. Thus, several studies investigated MCT in these patients, but the paper does not show that several demonstrated its clinical effect. (LLM, conf=0.86)

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Authors
Wells, A., Reeves, D., Heal, C., Davies, L. M., Shields, G. E., Heagerty, A., Fisher, P., Doherty, P., & Capobianco, L.
Affiliations
  • Manchester Academic Health Science Centre (GB)
  • University of Manchester (GB)
  • Manchester Royal Infirmary (GB)
  • University of Liverpool (GB)
  • University of York (GB)
  • Greater Manchester Mental Health NHS Foundation Trust (GB)
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2022-06-03
Volume
13
Pages
886407-886407
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2022.886407
PMC
PMC9204153
OpenAlex
W4281752275
Cited by
16
References
27
Citations by year
2026: 4 · 2025: 1 · 2024: 4 · 2023: 5 · 2022: 2
FWCI
2.09
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Research Explorer (The University of Manchester) (submittedVersion)
Funders
National Institute for Health Research (RP-PG-1211-20011)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords
metacognitive therapy, anxiety, depression, cardiovascular disease, cardiac rehabilitation, psychological intervention, metacognitive model, feasibility trial, acceptability, self-help intervention, group therapy, mental health outcomes

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