Protocol for an implementation study of group metacognitive therapy for anxiety and depression in NHS cardiac rehabilitation services in England (PATHWAY-Beacons).

Autor:	Wells A; Division of Psychology and Mental Health, School of Psychological Sciences, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, United Kingdom.; Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, National Health Service Foundation, Manchester, United Kingdom., Reeves D; NIHR School for Primary Care Research, Williamson Building, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.; Jean McFarlane Building, Faculty of Biology Medicine and Health, Centre for Biostatistics, School of Health Sciences, The University of Manchester, Manchester, United Kingdom., Belcher A; Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, National Health Service Foundation, Manchester, United Kingdom., Wilson P; NIHR School for Primary Care Research, Williamson Building, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom., Doherty P; Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom.; Department of Health Sciences, University of York, York, United Kingdom., Capobianco L; Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, National Health Service Foundation, Manchester, United Kingdom.
Jazyk:	angličtina
Zdroj:	Frontiers in health services [Front Health Serv] 2024 Oct 17; Vol. 4, pp. 1296596. Date of Electronic Publication: 2024 Oct 17 (Print Publication: 2024).
DOI:	10.3389/frhs.2024.1296596
Abstrakt:	Background: Cardiac rehabilitation (CR) services aim to improve heart disease patients' health and quality of life and reduce the risk of further cardiac events. Depression and anxiety are common among CR patients but psychological treatments have usually had small effects. In contrast, the recent NIHR-funded PATHWAY trial found that group Metacognitive Therapy (MCT) was associated with improvements in anxiety and depression when added to CR and was more effective than usual CR alone. The next stage is to test implementation of MCT within the National Health Service through the creation of a network of CR beacon sites. The study will test the quality of data capture following addition of a new MCT data-field to the national audit of cardiac rehabilitation (NACR), examine level of adoption at sites, examine mental health outcomes benchmarked against usual CR and the PATHWAY data, examine the enablers and barriers to implementation and the expected resource requirements. The study has been registered: NCT05956912 (13th July, 2023). Methods: Beacon sites will be recruited as preliminary adopters of group MCT from NHS CR services in England. A national invitation for expressions of interest from CR services will be issued and those meeting eligibility criteria will be considered for inclusion. Two staff at each site will receive training in MCT, and mixed-methods will be used to address questions concerning the quality of patient data recorded, level of adoption at sites, the characteristics of patients attending MCT, the impact of adding MCT to CR on mental health outcomes, and patient, healthcare staff and commissioner views of barriers/enablers to implementation. Exploration of implementation will be informed by Normalisation Process Theory. Discussion: The study will support development of an NHS roll-out strategy, assess the mental health outcomes associated with MCT, examine treatment fidelity in real-world settings, and evaluate revised data collection structures that can be used to assess the impact of national-level implementation. Trial Registration: NCT05956912; 13 th July 2023. Competing Interests: AW is the director of the MCT-Institute and developer of MCT. He has written books on cognitive behaviour therapy and MCT. He is chief investigator on grants; NIHR201495; NIHR35997, and co-CI on NIHR203634. LC is the chief investigator on NIHR203634, and PD is a co-applicant on grant NIHR203634. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2024 Wells, Reeves, Belcher, Wilson, Doherty and Capobianco.)
Databáze:	MEDLINE
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