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

Our primary aim is to improve access to more effective psychological interventions for the range of heart disease patients attending cardiac rehabilitation (CR) services. This will lead to better informed and integrated care within CR services and has the potential to improve psychological and physical well-being as well as reduce NHS costs.

Specifically, the study will compare whether a psychological intervention called Group-Metacognitive therapy (more information here) delivered to patients in addition to their usual CR sessions is more helpful for patients who are currently experiencing distress following a cardiac event than patients who only receive their usual CR sessions alone.

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 will take place at three NHS sites in the North West over a five year period.

First, we will run a pilot trial of the Group-Metacognitive Therapy intervention with 50 heart disease patients currently experiencing distress following a recent cardiac event. This will be followed by a full-scale randomised controlled trial (RCT) with 300 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