Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n = 76) or control (n = 69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points, respectively (p < 0.05). The control group showed reductions of 1.5 and 1.2 points (p < 0.05). The difference in the Hamilton Rating Scale for Depression between the groups at 12 months was −1.29 in favor of the main group (95% CI, −0.7 to −1.88), and the standardized mean difference was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study’s strengths include a structured intervention, randomization, and long-term follow-up. The limitations include the lack of blinding of study participants and a relatively small sample size.
Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n=76) or control (n=69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points respectively (p&lt;0.05). The control group showed reductions of 1.5 and 1.2 points (p&lt;0.05). The difference in depression (HRDS) between the groups at 12 months was -1.29 in favor of the main group (95% CI, -0.7 to -1.88), and the standardized effect size (SMD) was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study's strengths include a structured intervention, randomization, and long-term follow-up. Limitations include the lack of blinding of study participants and a relatively small sample size.
Background: Cardiovascular diseases (CVD) are the main causes of death worldwide. The incidence of and mortality from CVD in Kazakhstan is greater than in most neighboring countries warranting urgent public health measures related to both primary, secondary and tertiary prevention. Aims: To assess whether a newly developed 6-months public health rehabilitation program for patients with acute myocardial infarction (AMI) with home visits performed by physician assistants is superior to the standard rehabilitation of these patients in Western Kazakhstan. Methods: A randomized controlled study. A total of 75 AMI patients were enrolled after discharge form the hospital and 72 completed the trial. The control group (n = 34) participated in the standard rehabilitation program while the intervention group (n = 38) underwent and experimental rehabilitation program with home visits in addition to the standard program. Body mass index, waist circumference, blood pressure, heart rate, blood lipids, smoking and compliance to the treatment were assessed at the enrollment and after 6 months of the follow-up. Differences between the changes in the intervention and in the control group were compared using Mann-Whitney tests. Results: The experimental program was superior to the standard program in reducing systolic-(-22.5 vs. -2.9 mm Hg, p < 0.004) and diastolic (-6.3 vs. -0.6 mm Hg, p = 0.032) blood pressure, body mass index (-0.99 vs. 0.53 kg/m 2 , p < 0.001), waist circumference (-3.0 vs. 1.7 cm, p < 0.001) and the number of smoked cigarettes (-12 vs. -3, p = 0.002). Blood lipid profiles improved in both groups. Although slightly more pronounced changes were observed in the intervention group, the differences did not reach the level of statistical significance. Conclusions:The program was more effective on blood pressure, smoking and obesity-related indicators than the standard rehabilitation. Larger studies are warranted to corroborate our findings prior to implementation of the program in practice.
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