Baseline demographic and clinical characteristics.

Baseline demographic and clinical characteristics.</p

Patients with a reliable change in HADS total score by 4 months by treatment group, using complete cases.

Patients with a reliable change in HADS total score by 4 months by treatment group, using complete cases.</p

CONSORT Flowchart.

CR, cardiac rehabilitation; Home-MCT, home-based metacognitive therapy.</p

Home-MCT patient flow.

CR, cardiac rehabilitation; Home-MCT, home-based metacognitive therapy.</p

Summary of analyses of primary and secondary outcomes.

Summary of analyses of primary and secondary outcomes.</p

Mean HADS total scores and 95% confidence intervals for each trial arm at each assessment point, for complete cases only.

HADS, Hospital Anxiety and Depression Scale.</p

Patients with a minimal clinically important change in HADS total score by 4 months by treatment group, using complete cases.

Patients with a minimal clinically important change in HADS total score by 4 months by treatment group, using complete cases.</p

PATHWAY study: Statistical Analysis Plan for WS3+ RCT outcomes at 4 months.

(DOCX)</p

Additional file 1: of Improving the effectiveness of psychological interventions for depression and anxiety in the cardiac rehabilitation pathway using group-based metacognitive therapy (PATHWAY Group MCT): study protocol for a randomised controlled trial

Standard Protocol Items: Recommendations for Intervention Trials (SPIRIT) Checklist. (DOC 121 kb

Biochemical Screening for Nonadherence Is Associated With Blood Pressure Reduction and Improvement in Adherence.

We hypothesized that screening for nonadherence to antihypertensive treatment using liquid chromatography-tandem mass spectrometry-based biochemical analysis of urine/serum has therapeutic applications in nonadherent hypertensive patients. A retrospective analysis of hypertensive patients attending specialist tertiary care centers was conducted in 2 European countries (United Kingdom and Czech Republic). Nonadherence to antihypertensive treatment was diagnosed using biochemical analysis of urine (United Kingdom) or serum (Czech Republic). These results were subsequently discussed with each patient, and data on follow-up clinic blood pressure (BP) measurements were collected from clinical files. Of 238 UK patients who underwent biochemical urine analysis, 73 were nonadherent to antihypertensive treatment. Their initial urinary adherence ratio (the ratio of detected to prescribed antihypertensive medications) increased from 0.33 (0-0.67) to 1 (0.67-1) between the first and the last clinic appointments. The observed increase in the urinary adherence ratio in initially nonadherent UK patients was associated with the improved BP control; by the last clinic appointment, systolic and diastolic BPs were ≈19.5 and 7.5 mm Hg lower than at baseline (P=0.001 and 0.009, respectively). These findings were further corroborated in 93 nonadherent hypertensive patients from Czech Republic-their average systolic and diastolic BPs dropped by ≈32.6 and 17.4 mm Hg, respectively (P<0.001), on appointments after the biochemical analysis. Our data show that nonadherent hypertensive patients respond to liquid chromatography-tandem mass spectrometry-based biochemical analysis with improved adherence and significant BP drop. Such repeated biochemical analyses should be considered as a therapeutic approach in nonadherent hypertensive patients