Psychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis

Richards, S. H. et al. (2018) Psychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis. European Journal of Preventive Cardiology, 25(3), pp. 247-259. (doi:10.1177/2047487317739978) (PMID:29212370)

Richards, S. H. et al. (2018) Psychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis. European Journal of Preventive Cardiology, 25(3), pp. 247-259. (doi:10.1177/2047487317739978) (PMID:29212370)

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Abstract

Background: Although psychological interventions are recommended for the management of coronary heart disease (CHD), there remains considerable uncertainty regarding their effectiveness. Design: Systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for CHD. Methods: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL and PsycINFO were searched to April 2016. Retrieved papers, systematic reviews and trial registries were hand-searched. We included RCTs with at least 6 months of follow-up, comparing the direct effects of psychological interventions to usual care for patients following myocardial infarction or revascularisation or with a diagnosis of angina pectoris or CHD defined by angiography. Two authors screened titles for inclusion, extracted data and assessed risk of bias. Studies were pooled using random effects meta-analysis and meta-regression was used to explore study-level predictors. Results: Thirty-five studies with 10,703 participants (median follow-up 12 months) were included. Psychological interventions led to a reduction in cardiovascular mortality (rfcelative risk 0.79, 95% confidence interval [CI] 0.63 to 0.98), although no effects were observed for total mortality, myocardial infarction or revascularisation. Psychological interventions improved depressive symptoms (standardised mean difference [SMD] –0.27, 95% CI –0.39 to –0.15), anxiety (SMD –0.24, 95% CI –0.38 to –0.09) and stress (SMD –0.56, 95% CI –0.88 to –0.24) compared with controls. Conclusions: We found that psychological intervention improved psychological symptoms and reduced cardiac mortality for people with CHD. However, there remains considerable uncertainty regarding the magnitude of these effects and the specific techniques most likely to benefit people with different presentations of CHD.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Taylor, Professor Rodney Stephen
Authors: Richards, S. H., Anderson, L., Jenkinson, C. E., Whalley, B., Rees, K., Davies, P., Bennett, P., Liu, Z., West, R., Thompson, D. R., and Taylor, R. S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
Journal Name:European Journal of Preventive Cardiology
Publisher:SAGE
ISSN:2047-4873
ISSN (Online):2047-4881
Published Online:07 December 2017
Copyright Holders:Copyright © 2017 The European Society of Cardiology
First Published:First published in European Journal of Preventive Cardiology 25(3):247-259
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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