PATHWAY-Beacons

  • PATHWAY Beacons Logo
PATHWAY Beacons Logo

PATHWAY-Beacons

PATHWAY Beacons Logo

Professor Adrian Wells

Chief Investigator

2-year project

study name

Implementing Group Metacognitive Therapy in Cardiac Rehabilitation Services (PATHWAY-Beacons)

PATHWAY-Beacons is an NIHR research-funded study (NIHR202956) looking at the roll-out of group metacognitive therapy (MCT) into cardiac rehabilitation (CR) services.

Study Participants

  • CR staff, healthcare professionals working with CR, or NHS staff working at the commissioner level. 

Study Design

  • PATHWAY-Beacons is an implementation-focused study that will qualitatively assess the training of CR staff and their experiences in delivering group-MCT across CR services.
  • Beacons will also revise and pilot national data monitoring to capture group-MCT outcomes in CR.
  • We plan to recruit a minimum of 3 CR services to become Beacon sites.
  • Qualitative interviews will be conducted with approximately 8-10 CR staff trained in MCT and 8-10 management or commissioner-level staff at Beacon sites.

PATHWAY-Beacons Info

  • CR services aim to reduce the risk of patients experiencing further cardiac events and improve their health and quality of life.
  • Depression and anxiety are common among CR patients: 27.6% have symptoms of anxiety and 19% have symptoms of depression.
  • Previously talking-based therapies in cardiac patients have had little success in improving symptoms of anxiety and depression.
  • However, the NIHR-funded PATHWAY trial, found that a group-based therapy called Metacognitive Therapy (MCT) is effective at treating anxiety and depression and more effective than CR alone.
  • Following the success of PATHWAY, the next step involves understanding the factors that will facilitate or impair services from including MCT in their service
  • This information will help us plan roll-out across the UK.
  1. To assess cardiac rehab stakeholder’s views on delivering group MCT alongside cardiac rehabilitation to identify factors that will prevent or encourage them from implementing group MCT.
  2. To test the roll-out of group-MCT in CR services by testing the training and delivery of group MCT by CR staff in CR services nationally.
  3. To revise and pilot data capture within services following the modification of the National Audit of Cardiac Rehabilitation (NACR) dataset to include group-MCT.

These aims will help us to prepare for a large-scale rollout of group MCT within CR services.

  • Metacognitive Therapy (MCT) is an effective evidence-based psychological intervention.
  • MCT consists of 6 sessions of 90 minutes delivered weekly.
  • It regulates the thinking patterns and behaviours (e.g., worrying, rumination) that keep anxiety and depression going.
  • Group-MCT is more effective than CR alone at improving anxiety and depression.
  • MCT-PATHWAY is the UK’s first successful group-based mental health intervention that can be delivered alongside usual cardiac rehabilitation.
  • The National Institute of Health Research (NIHR) is providing funding to examine the roll-out of PATHWAY in 6 CR services across England in 2022 to prepare for wider scale roll-out of PATHWAY.
  • We are running a three-day training programme (hosted by Greater Manchester Mental Health NHS Foundation Trust and the University of Manchester) that will take place online in October 2022.
  • Following the training, 6 cardiac rehabilitation services at the following NHS trusts will be delivering group-MCT:
  • Patients and the public play a key role in ensuring research is accessible, meets patients’ needs and provides direct benefit to patients.
  • The PATHWAY-Beacons study is working with members of the public to get their opinions on adding a group-based talking therapy for anxiety and depression in cardiac rehabilitation services.
  • Watch the video to hear what our service users have to say about being a PPI member her.
Background
  • CR services aim to reduce the risk of patients experiencing further cardiac events and improve their health and quality of life.
  • Depression and anxiety are common among CR patients: 27.6% have symptoms of anxiety and 19% have symptoms of depression.
  • Previously talking-based therapies in cardiac patients have had little success in improving symptoms of anxiety and depression.
  • However, the NIHR-funded PATHWAY trial, found that a group-based therapy called Metacognitive Therapy (MCT) is effective at treating anxiety and depression and more effective than CR alone.
  • Following the success of PATHWAY, the next step involves understanding the factors that will facilitate or impair services from including MCT in their service
  • This information will help us plan roll-out across the UK.
Study Aims
  1. To assess cardiac rehab stakeholder’s views on delivering group MCT alongside cardiac rehabilitation to identify factors that will prevent or encourage them from implementing group MCT.
  2. To test the roll-out of group-MCT in CR services by testing the training and delivery of group MCT by CR staff in CR services nationally.
  3. To revise and pilot data capture within services following the modification of the National Audit of Cardiac Rehabilitation (NACR) dataset to include group-MCT.

These aims will help us to prepare for a large-scale rollout of group MCT within CR services.

Treatment
  • Metacognitive Therapy (MCT) is an effective evidence-based psychological intervention.
  • MCT consists of 6 sessions of 90 minutes delivered weekly.
  • It regulates the thinking patterns and behaviours (e.g., worrying, rumination) that keep anxiety and depression going.
  • Group-MCT is more effective than CR alone at improving anxiety and depression.
Study Progress
  • MCT-PATHWAY is the UK’s first successful group-based mental health intervention that can be delivered alongside usual cardiac rehabilitation.
  • The National Institute of Health Research (NIHR) is providing funding to examine the roll-out of PATHWAY in 6 CR services across England in 2022 to prepare for wider scale roll-out of PATHWAY.
  • We are running a three-day training programme (hosted by Greater Manchester Mental Health NHS Foundation Trust and the University of Manchester) that will take place online in October 2022.
  • Following the training, 6 cardiac rehabilitation services at the following NHS trusts will be delivering group-MCT:
PPI
  • Patients and the public play a key role in ensuring research is accessible, meets patients’ needs and provides direct benefit to patients.
  • The PATHWAY-Beacons study is working with members of the public to get their opinions on adding a group-based talking therapy for anxiety and depression in cardiac rehabilitation services.
  • Watch the video to hear what our service users have to say about being a PPI member her.

Testimonial

  • Simon FittonPATHWAY Participant

    I now have a very active lifestyle and walk every day (usually five miles!). My quality of life is much improved, and my mental well-being is very good.

Project Timeline

Stage 1

(Months 1-6): Project set up, ethical approval, training of therapists, site recruitment, and qualitative interviews.

Stage 2

(Months 7-20): Participant recruitment, treatment delivery, follow-up data collection.

Stage 3

(Months 21-24): Data analysis, project write-up, and dissemination.

FAQs

YoMeta Study FAQ
What is the purpose of the study?
What does the study involve?
What does Metacognitive Therapy (MCT) involve?
What is Patient and Public Involvement (PPI)?

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.

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