The Effect of Telephone Support Interventions on Coronary Artery Disease (CAD) Patient Outcomes during Cardiac Rehabilitation: A Systematic Review and Meta-Analysis

Abstract

BackgroundCardiac rehabilitation is offered to individuals after cardiac events to aid recovery and reduce the likelihood of further cardiac illness. However, patient participation remains suboptimal and the provision of high quality care to an expanding population of patients with chronic heart conditions is becoming increasingly difficult. A systematic review and meta-analysis was conducted to determine the effect of telephone support interventions compared with standard post-discharge care on coronary artery disease patient outcomes.MethodsThe Cochrane Library, MEDLINE, EMBASE, and CINAHL were searched and randomized controlled trials that directly compared telephone interventions with standard post-discharge care in adults following a myocardial infarction or a revascularization procedure were included. Study selection, data extraction and quality assessment were completed independently by two reviewers. Where appropriate, outcome data were combined and analyzed using a random effects model. For each dichotomous outcome, odds ratios (OR) and 95% confidence intervals (CI) were derived for each outcome. For continuous outcomes, weighted mean differences (WMD) and standardized mean differences (SMD) and 95% CI were calculated.Results26 studies met the inclusion criteria. No difference was observed in mortality between the telephone group and the group receiving standard care OR 1.12 (0.71, 1.77). The intervention was significantly associated with fewer hospitalizations than the comparison group OR 0.62 (0.40, 0.97). Significantly more participants in the telephone group stopped smoking OR 1.32 (1.07, 1.62); had lower systolic blood pressure WMD −0.22 (−0.40, −0.04); lower depression scores SMD −0.10 (−0.21, −0.00); and lower anxiety scores SMD −0.14 (−0.24, −0.04). However, no significant difference was observed for low-density lipoprotein levels WMD −0.10 (−0.23, 0.03).ConclusionsCompared to standard post-discharge care, regular telephone support interventions may help reduce feelings of anxiety and depression as well as, improve systolic blood pressure control and the likelihood of smoking cessation.

Investigating the Effect of Telenursing on Health Promoting Behaviours of Haemodialysis Patients in Education Hospitals in Zahedan in 2017-2018

“…(23) At the end, the researchers concluded that tele-nursing as a preventive method can cause improved glycemia of patients. (24) Also, the review study by Kotb et al (2014) testing the extent of compliance with treatment in patients with coronary artery disease, also confirmed the results of the present study. They found that telephone follow-up resulted in diminished rehospitalization of patients in hospital as well as reduced systolic blood pressure and depression.…”

“…They found that telephone follow-up resulted in diminished rehospitalization of patients in hospital as well as reduced systolic blood pressure and depression. (24) The results of a study by Behzad et al (2015) entitled the effect of empowerment program (self-care workshop) based on telephone follow-up (Tele-nursing) emphasized selfefficacy in promoting self-efficacy in self-care behaviours of the elderly with hypertension. (25) In the study by Boraz et al entitled "comparing the effect of in person and distance education of self-care on the quality of life and physical problems of patients undergoing haemodialysis maintenance therapy, they found that most of the studied variables including laboratory tests, blood pressure, weight gain between two sessions of dialysis, pruritus, oedema, and warmness of the vascular pathway in each of the groups of in person and distant education, changed significantly before and after the education.…”

Health education for patients with acute coronary syndrome and type 2 diabetes mellitus: an umbrella review of systematic reviews and meta-analyses

“…There is some evidence that telephone-based health education during cardiac rehabilitation might improve all-cause hospitalisation, anxiety, depression, smoking cessation and systolic BP, but there is no evidence for improvements in all-cause mortality and reductions in low-density lipoprotein cholesterol. 59 …”

“…Telephone-based health education appeared to be effective for reducing hospitalisations, systolic BP, smoking rates, depression and anxiety. 59 The educational interventions for patients with ACS focused primarily on clinical outcomes (hospitalisation and mortality), modifiable risk factors (BP, low-density lipoprotein levels and smoking cessation) and other psychological outcomes (anxiety and depression).…”

Nurse-led telephone-based follow-up of secondary prevention after acute coronary syndrome: One-year results from the randomized controlled NAILED-ACS trial

“…New methods for outpatient secondary preventive follow-up have been called for, and the involvement of healthcare staff other than physicians, such as nurses and pharmacists, as well as new regimens of follow-up are recommended in the latest guidelines [ 5 ]. In small studies, telemedical methods have had interesting results in improving both adherence to medication and risk factors in the short-term [ 6 , 7 ]. A more effective secondary preventive strategy must be both cost effective and easily implemented in today’s health care systems, with applicability to a large part of the target population and flexibility to meet each individual´s needs.…”