Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT

Project report

Thomas, S., Drummond, A., Lincoln, N., Palmer, R., das Nair, R., Latimer, N., Hackney, G., Mandefield, L., Walters, S., Hatton, R., Cooper, C., Chater, T., England, R., Callaghan, P., Coates, E., Sutherland, K., Eshtan, S.J. and Topcu, G. (2019). Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT. National Institute for Health Research. https://doi.org/10.3310/hta23470
AuthorsThomas, S., Drummond, A., Lincoln, N., Palmer, R., das Nair, R., Latimer, N., Hackney, G., Mandefield, L., Walters, S., Hatton, R., Cooper, C., Chater, T., England, R., Callaghan, P., Coates, E., Sutherland, K., Eshtan, S.J. and Topcu, G.
TypeProject report
Abstract

Approximately one-third of stroke patients experience depression, which can have negative effects on
recovery and quality of life (QoL). Currently, we do not have sufficient evidence to indicate which
psychological interventions are effective and affordable to the NHS for treating post-stroke depression.
We aimed to determine whether or not it is feasible to conduct a future large-scale study to evaluate a
psychological intervention, called behavioural activation (BA) therapy, for treating post-stroke depression.
BA aims to improve mood by identifying what stroke patients enjoy doing and helping them to undertake
these activities. BA can be used with all stroke patients with depression, including people with cognitive or
communication difficulties.
We recruited 48 post-stroke patients who had suffered a stroke between 3 months and 5 years previously.
People with dementia or significant aphasia were excluded. Participants were divided into two groups at
random. About half of the participants received BA over a 4-month period and the other half did not.
Participants received all other available care. After 6 months, participants completed questionnaires about
their mood, activity level and QoL. We also interviewed 16 participants and 10 carers about their views on
the actual research process and therapy.
Although we were able to recruit participants to the study, we recruited fewer than the original target
of 72 participants owing to delays in starting recruitment. However, we have identified ways to improve
participant recruitment in a future study. We found that it was feasible to deliver BA, and the therapy
was found to be acceptable to participants, carers and therapists. The results indicate that the benefits of
conducting a large-scale future study would outweigh the costs. However, the main consideration will be
whether or not we could identify enough stroke services able to run the study for a long enough period to
recruit the large number of participants required.

KeywordsStroke; Behavioural Activation; Depression; Feasibility
Year2019
PublisherNational Institute for Health Research
ISSN1366-5278
Digital Object Identifier (DOI)https://doi.org/10.3310/hta23470
Web address (URL)https://www.journalslibrary.nihr.ac.uk/hta/hta23470#/abstract
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Print16 Sep 2019
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Accepted01 Mar 2018
Deposited12 Nov 2019
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