Psychological interventions for coronary heart disease

Richards, Suzanne H; Anderson, Lindsey; Jenkinson, Caroline E; Whalley, Ben; Rees, Karen; Davies, Philippa; Bennett, Paul; Liu, Zulian; West, Robert; Thompson, David R.; Taylor, Rod S

doi:10.1002/14651858.cd002902.pub4

Cited by 252 publications

(176 citation statements)

References 243 publications

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“…4 An observational multicentre study reported higher mortality at one year in patients with untreated depression after myocardial infarction than in those without depression. 60 Psychological interventions alleviate symptoms, 61 and studies are under way to assess the role of enhanced psychological therapy within rehabilitation. 62 Therapeutic options include stress management, management of depression, and referral to a clinical psychologist.…”

Section: Psychological Impactmentioning

confidence: 99%

Management of patients after primary percutaneous coronary intervention for myocardial infarction

Dalal

Voukalis

et al. 2017

BMJ

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Section: Psychological Impactmentioning

confidence: 99%

Management of patients after primary percutaneous coronary intervention for myocardial infarction

Dalal

Voukalis

et al. 2017

BMJ

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“…A recent Cochrane review has shown comprehensive CR, including elements of stress management and exercise training, can have significant positive effects in terms in reductions in depression and anxiety of myocardial infarction and postrevascularisation populations. 34 The observed trend towards a reduction in depression and anxiety scores with the REACH-HF intervention points towards a possible basis of improvement in the mental component of HRQoL.…”

Section: Discussionmentioning

confidence: 95%

A randomised controlled trial of a facilitated home-based rehabilitation intervention in patients with heart failure with preserved ejection fraction and their caregivers: REACH-HFpEF pilot study

et al. 2018

Self Cite

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BackgroundHome-based models of cardiac rehabilitation may overcome suboptimal rates of participation.AimThis study sought to assess the feasibility and acceptability of a novel healthcare professional facilitated home-based comprehensive self-management REACH-HF rehabilitation intervention for patients with heart failure with preserved ejection fraction (HFpEF) and their caregivers.MethodPatients were randomised 1 to the REACH-HF intervention plus usual care (intervention group) or usual care alone (control group). Outcomes were collected at baseline, 3 and 6 months post-randomisation. Outcomes were also collected in caregivers.ResultsWe enrolled 50 symptomatic patients with a left ventricular ejection fraction ≥ 45% (mean age: 73.9 years, 54% female: 96% in NYHA II/III) and 21 caregivers. Study retention (90%) and intervention uptake (92%) were excellent. At 6 months, a number of patient outcomes showed a potential direction of effect in favour of the intervention group, including the primary outcome of Minnesota Living with Heart Failure Questionnaire total score (between group mean difference: −11.5, 95% confidence interval: −22.8 to 0.3). A total of 11 (4 intervention, 7 control) patients experienced a hospital admission over the 6 months follow up with 4 (all control patients) of these admissions being HF-related. Improvements were seen in a number intervention caregiver mental health and burden compared to control.ConclusionOur findings support the feasibility and rationale for the delivering the REACH-HF facilitated home-based rehabilitation intervention for patients with HFpEF and their caregivers and progression to a full multicentre randomised clinical trial to test the clinical and cost-effectiveness of this novel intervention.

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“…According to Richards [7], future large-scale trials testing the effectiveness of psychological therapies are required due to the uncertainties within the evidence. Future trials would benefit from testing the impact of specific (rather than multifactorial) psychological interventions on patients with CHD, and testing the targeting of interventions to different patient populations (i.e., people with CHD, with or without psychopathologies).…”

Section: Discussionmentioning

confidence: 99%

“…The updated Cochrane Review [7] found that for people with CHD there was no evidence that psychological treatments had an effect on total mortality, risk of revascularisation procedures, or on the rate of non-fatal AMI, although the rate of cardiac mortality was reduced and there was a reduction in psychological symptoms (depression, anxiety, or stress); however, the GRADE assessments suggest considerable uncertainty surrounding these effects. There is also considerable uncertainty about who would benefit most from treatment (i.e., people with or without psychological disorders at baseline) and what the specific components of successful interventions are.…”

Section: Reviewmentioning

confidence: 99%

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper

Angelino

Porta

Abatello

et al. 2018

Monaldi Arch Chest Dis

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Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability. The steps followed were: i) a review of the latest international guidelines and position papers; ii) analysis of the evidence-based literature; iii) a qualitative analysis of the psychological services operating in some reference Italian cardiac rehabilitation facilities; iv) classification of the psychological activities in CPR as low or high intensity based on the NICE Guidelines on psychological interventions on anxiety and depression. We confirm the existence of an association between depression, anxiety, social factors, stress, personality and illness onset/outcome and coronary heart disease. Evidence for an association between depression, social factors and disease outcome emerges particularly for chronic heart failure. Some positive psychological variables (e.g., optimism) are associated to illness outcome. Evidence is reported on the impact of psychological activities on 'new' conditions which are now indicated for cardiac rehabilitation: pulmonary hypertension, grown-up congenital heart, end-stage heart failure, implantable cardioverter-defribrillator and mechanical ventricular assist devices, frail and oldest-old patients, and end-of-life care. We also report evidence related to caregivers. The Panel divided evidence-based psychological interventions into: i) low intensity (counseling, psycho-education, self-care, self-management, telemedicine, self-help); or ii) high intensity (individual, couples and/or family and group psychotherapy, such as stress management). The results show that psychotherapy is mainly consisting of cognitive-behavior therapy, interpersonal therapy, and short-term psycho-dynamic therapy. The current data further refine the working tools available for psychological activities in CPR, giving clear directions about the choice of interventions, which should be evidence-based and have at least a minimum standard. This document provides a comprehensive update on new knowledge and new paths for psychologists working in the CPR settings.

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Psychological interventions for coronary heart disease

Cited by 252 publications

References 243 publications

Management of patients after primary percutaneous coronary intervention for myocardial infarction

Management of patients after primary percutaneous coronary intervention for myocardial infarction

A randomised controlled trial of a facilitated home-based rehabilitation intervention in patients with heart failure with preserved ejection fraction and their caregivers: REACH-HFpEF pilot study

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper

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