The PATHWAY trial is a research programme led by Professor Adrian Wells, which aimed to evaluate ways to improve mental health outcomes for cardiac rehabilitation patients. The trials evaluated two formats of metacognitive therapy: group-based MCT and home-based MCT.

Group-based MCT was delivered face to face by cardiac rehabilitation staff, while home-based MCT was paper-based and a self-directed intervention.

Each version of MCT was compared against usual cardiac rehabilitation alone in separate randomized controlled trials. Group-MCT plus usual cardiac rehabilitation was found to significantly decrease symptoms of anxiety and depression in comparison to cardiac rehabilitation alone at both 4-month and 12-month follow up (SMD = 0.52, and 0.33 respectively). Similarly, when Home-MCT was compared to usual cardiac rehabilitation alone, the results favoured home-MCT (SMD = 0.38)

The programme included both qualitative, health economic, and patient and public involvement work throughout. For further details on the trials and associated work click here.