BEADS Trial

Behavioural Activation therapy for Depression after Stroke.

Off

The Challenge

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.

The Research

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 research process and the therapy.

The Results

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 would 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 for a full trial which could provide a definitive answer about the effectiveness of BA therapy for people with depression post-stroke.

The Impact

Potential to inform the next update of the stroke clinical guidelines.

Presentations on behavioural activation have been delivered at local and national conferences.

Publications

  • Thomas SA, Drummond AER, Lincoln NB, Palmer RL, das Nair R, Latimer NR, et al. Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT. Health Technol Assess 2019;23(47)
  • Behavioural Activation Therapy for Depression after Stroke (BEADS): a study protocol for a feasibility randomised controlled pilot trial of a psychological intervention for post-stroke depression. Thomas, S.A., Coates, E., das Nair, R. et al. (10 more authors) (2016)  Pilot and Feasibility Studies, 2 (1).
  • Behavioural activation therapy for depression after stroke (BEADS): a feasibility randomised controlled pilot trial of a psychological intervention for post-stroke depression. Thomas SA, Drummond A, Lincoln NB, Palmer R, das Nair R, Latimer NHackney G, Hatton R, Walters SMandefield Let al. INTERNATIONAL JOURNAL OF STROKE. 12: 15-15. Nov 2017 . Conference proceedings

Study staff

Name Role Site Contact
Shirley Thomas Chief Investigator Division of Rehabilitation & Ageing
University of Nottingham
shirley.thomas@nottingham.ac.uk
+44 115 846 7484
Gemma Hackney Trial Manager (maternity cover) Clinical Trials Research Unit (CTRU)
The University of Sheffield
g.hackney@sheffield.ac.uk
+44 114 222 4320
Zoe Furniss Trials Support Officer Clinical Trials Research Unit (CTRU)
The University of Sheffield
z.furniss@sheffield.ac.uk
+44 114 225 9122
Stephen Walters Senior Statistician Clinical Trials Research Unit (CTRU)
The University of Sheffield
s.j.walters@sheffield.ac.uk
+44 114 272 4095
Laura Mandefield Statistician Clinical Trials Research Unit (CTRU)
The University of Sheffield
l.mandefield@sheffield.ac.uk
+44 114 22 20750
Nick Latimer Health Economist Clinical Trials Research Unit (CTRU)
The University of Sheffield
n.latimer@sheffield.ac.uk
+44 114 272 4095
Tim Chater Data Manager Clinical Trials Research Unit (CTRU)
The University of Sheffield
t.chater@sheffield.ac.uk
+44 114 22 20876
Saleema Rex Data Analyst Clinical Trials Research Unit (CTRU)
The University of Sheffield
s.rex@sheffield.ac.uk
+44 114 22 20737
Cindy Cooper CTRU Director Clinical Trials Research Unit (CTRU)
The University of Sheffield
c.l.cooper@sheffield.ac.uk
+44 114 22 20749
Professor Patrick Callaghan Co-Investigator University of Nottingham patrick.callaghan@nottingham.ac.uk
Professor Avril Drummond Chief Investigator (maternity cover) University of Nottingham avril.drummond@nottingham.ac.uk
Associate Professor Timothy England Co-Investigator University of Nottingham timothy.england@nottingham.ac.uk
Professor Nadina Lincoln Co-Investigator University of Nottingham nadina.lincoln@nottingham.ac.uk
Dr Roshan das Nair Co-Investigator Nottingham University Hospitals NHS Trust roshan.nair@nottingham.ac.uk
Dr Rebecca Palmer Co-Investigator University of Sheffield r.l.palmer@sheffield.ac.uk

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