Acceptability and feasibility of groups for specific versus mixed-diagnosis patients with long-term conditions

Abstract

Background: Many people live with long-term conditions and subsequent difficulties with their mental health. Demand on psychological services is high, and initiatives need to address barriers to accessing these services. Group programmes use resources efficiently, but the relative effectiveness of different types of groups is unknown. This research adapted an evidenced-based acceptance and commitment therapy group intervention. It aimed to compare the feasibility, acceptability and preliminary effectiveness of this intervention, among specific-diagnosis and mixed-diagnosis groups. Methods A mixed methods pilot and feasibility study. Participants attended a specific-diagnosis or mixed-diagnosis group. The intervention comprised of 7, two-hour weekly sessions with an 8-week follow-up session. Outcomes included health-related quality of life, illness perceptions, depression, and anxiety, measured at baseline, post-intervention, and 8-week follow-up. Subsequently participants and health professionals (facilitators and referrers) attended qualitative interviews which explored their views on acceptability, informed by the Theoretical Framework of Acceptability. Results Both group conditions had similar improvements in psychological distress, illness perceptions and health-related quality of life, with significant improvements across time for anxiety, depression, energy, emotions, and general health. There was no overall differential effect of group, or a group by time interaction on any of the outcomes. Feasibility measures including retention (attended at least 3 sessions), true completion (attended all 8 sessions) and mean adherence rates were high and comparable across both group conditions. Acceptability was high across patient and health professional perspectives, with no marked difference between group conditions. Conclusions Pilot and feasibility testing revealed the intervention was feasible and acceptable in both group conditions. This preliminary data indicated a similar degree of improvement across group conditions. A randomised controlled trial and further comparative research is necessary to confirm tentative findings. This research indicates that services could flexibly plan their resources, based on patient need and capacity demands.