Psychological interventions for patients with coronary heart disease and their partners: a systematic review.

Abstract

OBJECTIVES: Despite evidence that patients with coronary heart disease (CHD) and their partners report significant psychological distress, and suggestions that involving partners in interventions alleviates such distress, no systematic reviews have examined this. The objective of this study was to systematically review evidence on the effectiveness of psychological interventions for patients with CHD and their partners. METHODS: CENTRAL, Medline, EMBASE, CINAHL and PsycINFO databases were searched through October 2012. Randomized controlled trials evaluating psychological interventions for patients with CHD and their partners were included. Selection of studies, study appraisal, data extraction and analysis were undertaken using standard methods. RESULTS: Seven studies comprising 673 participants were included, two of which indicated that psychological interventions result in modest improvements in patients' depressive symptoms, anxiety, knowledge of disease and treatment, and satisfaction with care, and in partners' anxiety, knowledge and satisfaction. In partners, there was a non-significant trend for improvements in depressive symptoms. One study showed a beneficial effect on blood pressure. There was no evidence of a significant effect on mortality, morbidity or cardiovascular risk factors for patients or social support for patients and partner. CONCLUSIONS: The small number of studies included in the review had generally poor methodology, as shown by the risk of bias, and were performed over 10 years ago. As only two of the seven studies resulted in modest improvements in outcomes, no firm conclusions can be drawn as to the effectiveness of such interventions in this population.