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. 2012 Dec 12:13:119.
doi: 10.1186/1471-2296-13-119.

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

Elizabeth A Barley  1 , Mark Haddad, Rosemary Simmonds, Zoe Fortune, Paul Walters, Joanna Murray, Diana Rose, André Tylee
Affiliations

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

Elizabeth A Barley et al. BMC Fam Pract. .

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.

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Figures

Figure 1
Figure 1
UPBEAT intervention MRC development stage. Feasibility and piloting, Evaluation and Implementation stages are ongoing.
Figure 2
Figure 2
Personalised care planning. UPBEAT-UK intervention assessment stage and initial care planning.
Figure 3
Figure 3
Follow up care. UPBEAT-UK intervention follow up care stage.
See this image and copyright information in PMC

References

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