Richards, SH orcid.org/0000-0003-1416-0569, Anderson, L, Jenkinson, CE et al. (8 more authors) (2018) Psychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis. European Journal of Preventive Cardiology, 25 (2). pp. 247-259. ISSN 2047-4873
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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017, The European Society of Cardiology. This is an author produced version of a paper published in European Journal of Preventive Cardiology. Reprinted by permission of SAGE Publications. |
Keywords: | Cardiac morbidity, mortality, depression, anxiety, stress, psychological intervention, systematic review, randomised controlled trial |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 12 Dec 2017 16:19 |
Last Modified: | 11 Apr 2018 11:34 |
Status: | Published |
Publisher: | SAGE Publications |
Identification Number: | 10.1177/2047487317739978 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:125057 |
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