Efficacy of psychosocial interventions on psychological outcomes among people with cardiovascular diseases: a systematic review and meta-analysis.

Abstract

OBJECTIVES: This systematic review aimed to examine empirical evidence concerning the efficacy of psychosocial interventions in ameliorating the psychosocial problems of people with cardiovascular diseases (CVDs). METHODS: A comprehensive literature search was undertaken to identify both published and non-published English randomised controlled trials (RCTs) from 2000 to 2015. Two reviewers independently screened, assessed risks for bias, and extracted data. Comprehensive meta-analysis software was used to analyse the extracted data. Hedges's g effect size was used to determine the effects of psychosocial interventions. RESULTS: Thirty studies were included in the review but only 18 studies reported significant short-term effects of psychosocial interventions in CVD patients. Most studies did not report long-term effects. Average effect sizes for stress, anxiety, depression, and combined depression/anxiety were 0.34, 1.04, 0.42 and 0.67 respectively at post-tests. Those numbers became 0.09, 0.65, 0.22 and 0.09 at follow-up assessments. Psychosocial programmes with psychoeducation and stress management helped reduce patients' stress and anxiety levels. Programmes including psychotherapy, counselling, mindfulness-based intervention (MBI), and stress management helped mitigate depression and anxiety. CONCLUSIONS: The findings support the efficacy of some psychosocial interventions in people with CVDs. PRACTICE IMPLICATIONS: Healthcare providers should monitor patients' psychological problems and may integrate psychosocial interventions as part of treatment plans.