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The UPBEAT depression and coronary heart disease programme: using the UK Medical Research Council framework to design a nurse-led complex intervention for use in primary care

Barley, E. A., Haddad, M. ORCID: 0000-0002-4822-5482, Simmonds, R. , Fortune, Z., Walters, P., Murray, J., Rose, D. & Tylee, A. (2012). The UPBEAT depression and coronary heart disease programme: using the UK Medical Research Council framework to design a nurse-led complex intervention for use in primary care. BMC Family Practice, 13, 119. doi: 10.1186/1471-2296-13-119

Abstract

Background
Depression is common in coronary heart disease (CHD) and increases the incidence of coronary symptoms and death in CHD patients. Interventions feasible for use in primary care are needed to improve both mood and cardiac outcomes. The UPBEAT-UK programme of research has been funded by the NHS National Institute for Health Research (NIHR) to explore the relationship between CHD and depression and to develop a new intervention for use in primary care.

Methods
Using the Medical Research Council (MRC) guidelines for developing and evaluating complex interventions, we conducted a systematic review and qualitative research to develop a primary care-based nurse-led intervention to improve mood and cardiac outcomes in patients with CHD and depression. Iterative literature review was used to synthesise our empirical work and to identify evidence and theory to inform the intervention.

Results
We developed a primary care-based nurse-led personalised care intervention which utilises elements of case management to promote self management. Following biopsychosocial assessment, a personalised care plan is devised. Nurses trained in behaviour change techniques facilitate patients to address the problems important to them. Identification and utilisation of existing resources is promoted. Nurse time is conserved through telephone follow up.

Conclusions
Application of the MRC framework for complex interventions has allowed us to develop an evidence based intervention informed by patient and clinician preferences and established theory. The feasibility and acceptability of this intervention is now being tested further in an exploratory trial.

Publication Type: Article
Publisher Keywords: Aged, Aged, 80 and over, Attitude of Health Personnel, Case Management, Cohort Studies, Coronary Disease, Delivery of Health Care, Depression, Female, General Practice, Great Britain, Health Services Accessibility, Humans, Male, Middle Aged, Nurse's Practice Patterns, Patient Care Planning, Patient Education as Topic, Patient-Centered Care, Primary Health Care, Program Development, Self Care
Subjects: R Medicine > RT Nursing
Departments: School of Health Sciences > Nursing
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