Research Projects

 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: 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.