Key result
Home-based self-help metacognitive therapy added to cardiac rehabilitation significantly reduced total anxiety and depression scores compared to cardiac rehabilitation alone (adjusted mean difference -2.64).
Why the study?
Current psychological interventions in cardiac rehabilitation have small effects based on low-quality studies of clinic-based interventions, with limited access to home-based psychological support.
Does adding home-based self-help metacognitive therapy to usual cardiac rehabilitation reduce anxiety and depression in cardiovascular disease patients?
Population
240 cardiac rehabilitation patients from 5 NHS-Trusts across North West England
Comparison
Home-MCT plus CR vs usual CR alone
Design
Single-blind multicentre two-arm RCT
Follow-up
4-month
Authors
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May support adjunctive use in cardiac rehabilitation; leaves open cost-effectiveness, durability, and need for confirmatory trials.
RCT (n=240)
Single-blind
1:1 via randomised blocks within hospital site
Yes
Does adding home-based self-help metacognitive therapy to usual cardiac rehabilitation reduce anxiety and depression in cardiovascular disease patients?
Mean Difference: -2.64 (95% CI -4.49–-0.78)
Absolute Event Rate: 15.17% vs 17.06%
p-value: p=0.005
Adding home-based self-help metacognitive therapy to standard cardiac rehabilitation significantly improves anxiety and depression symptoms in cardiovascular disease patients.
Wells et al. (2023) conducted an RCT in Cardiovascular disease with anxiety and/or depression (n=240). Home-based self-help metacognitive therapy (Home-MCT) vs. Usual cardiac rehabilitation (CR) alone was evaluated on Hospital Anxiety and Depression Scale (HADS) total score at 4-month follow-up (MD -2.64, 95% CI -4.49 to -0.78, p=0.005). Home-based self-help metacognitive therapy added to cardiac rehabilitation significantly reduced total anxiety and depression scores compared to cardiac rehabilitation alone (adjusted mean difference -2.64).
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