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Assessing the effectiveness of enhanced psychological care for patients with depressive symptoms attending cardiac rehabilitation compared with treatment as usual (CADENCE): study protocol for a…

Overview of attention for article published in Trials, February 2016
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Title
Assessing the effectiveness of enhanced psychological care for patients with depressive symptoms attending cardiac rehabilitation compared with treatment as usual (CADENCE): study protocol for a pilot cluster randomised controlled trial
Published in
Trials, February 2016
DOI 10.1186/s13063-016-1184-9
Pubmed ID
Authors

Suzanne H. Richards, Chris Dickens, Rob Anderson, David A. Richards, Rod S. Taylor, Obioha C. Ukoumunne, David Kessler, Katrina Turner, Willem Kuyken, Manish Gandhi, Luke Knight, Andrew Gibson, Antoinette Davey, Fiona Warren, Rachel Winder, Christine Wright, John Campbell

Abstract

Around 17 % of people eligible for UK cardiac rehabilitation programmes following an acute coronary syndrome report moderate or severe depressive symptoms. While maximising psychological health is a core goal of cardiac rehabilitation, psychological care can be fragmented and patchy. This study tests the feasibility and acceptability of embedding enhanced psychological care, composed of two management strategies of proven effectiveness in other settings (nurse-led mental health care coordination and behavioural activation), within the cardiac rehabilitation care pathway. This study tests the uncertainties associated with a large-scale evaluation by conducting an external pilot trial with a nested qualitative study. We aim to recruit and randomise eight comprehensive cardiac rehabilitation teams (clusters) to intervention (embedding enhanced psychological care into routine cardiac rehabilitation programmes) or control (routine cardiac rehabilitation programmes alone) arms. Up to 64 patients (eight per team) identified with depressive symptoms upon initial assessment by the cardiac rehabilitation team will be recruited, and study measures will be administered at baseline (before starting rehabilitation) and at 5 months and 8 months post baseline. Outcomes include depressive symptoms, cardiac mortality and morbidity, anxiety, health-related quality of life and service resource use. Trial data on cardiac team and patient recruitment, and the retention and flow of patients through treatment will be used to assess intervention feasibility and acceptability. Qualitative interviews will be undertaken to explore trial participants' and cardiac rehabilitation nurses' views and experiences of the trial methods and intervention, and to identify reasons why patients declined to take part in the trial. Outcome data will inform a sample size calculation for a definitive trial. The pilot trial and qualitative study will inform the design of a fully powered cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of the provision of enhanced psychological care within cardiac rehabilitation programmes. ISRCTN34701576 (Registered 29 May 2014).

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 135 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Unknown 134 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 21 16%
Researcher 19 14%
Student > Ph. D. Student 15 11%
Student > Bachelor 14 10%
Student > Doctoral Student 10 7%
Other 18 13%
Unknown 38 28%
Readers by discipline Count As %
Medicine and Dentistry 29 21%
Nursing and Health Professions 28 21%
Psychology 22 16%
Social Sciences 4 3%
Arts and Humanities 2 1%
Other 7 5%
Unknown 43 32%