Universität zu Köln

Albus, Christian, Herrmann-Lingen, Christoph, Jensen, Katrin, Hackbusch, Matthes, Muench, Nina, Kuncewicz, Catharina, Grilli, Maurizio, Schwaab, Bernhard and Rauch, Bernhard (2019). Additional effects of psychological interventions on subjective and objective outcomes compared with exercise-based cardiac rehabilitation alone in patients with cardiovascular disease: A systematic review and meta-analysis. Eur. J. Prev. Cardiol., 26 (10). S. 1035 - 1050. LONDON: SAGE PUBLICATIONS LTD. ISSN 2047-4881

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Abstract

Background Exercise-based cardiac rehabilitation (ebCR) often includes various psychological interventions for lifestyle change or distress management. However, the additional benefit of specific psychological interventions on depression, anxiety, quality of life, cardiac morbidity and cardiovascular or total mortality is not well investigated. Design Systematic review and meta-analysis. Methods Randomized controlled trials and controlled cohort trials published between January 1995 and October 2017 comparing ebCR with or without pre-specified psychosocial interventions were selected and evaluated on the basis of predefined inclusion and outcome criteria. Results Out of 15,373 records, 20 studies were identified, including 4450 patients with coronary artery disease (88.5%) or congestive heart failure (11.5%), respectively. Studies were of low to moderate quality and methodological heterogeneity was high. As compared with ebCR alone, additional psychological interventions for lifestyle change or distress management showed a trend to reduce depressive symptoms (standardized mean difference -0.13, 95% confidence interval (CI) -0.30; 0.05). Furthermore, during a follow-up of five years, distress management was associated with a trend to reduce cardiac morbidity (risk ratio 0.74, 95% CI 0.51; 1.07). There was no evidence for an additional impact of either psychological lifestyle change interventions or distress management on anxiety, quality of life, cardiovascular or total mortality. Conclusions Specific psychological interventions offered during ebCR may contribute to a reduction of depressive symptoms and cardiac morbidity, but there remains considerable uncertainty under which conditions these interventions exert their optimal effects. (CRD42015025920).

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Albus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrmann-Lingen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Jensen, Katrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hackbusch, Matthes UNSPECIFIED UNSPECIFIED UNSPECIFIED Muench, Nina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuncewicz, Catharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Grilli, Maurizio UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwaab, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Rauch, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-136981
DOI:	10.1177/2047487319832393
Journal or Publication Title:	Eur. J. Prev. Cardiol.
Volume:	26
Number:	10
Page Range:	S. 1035 - 1050
Date:	2019
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	2047-4881
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CORONARY-HEART-DISEASE; COGNITIVE-BEHAVIORAL THERAPY; RANDOMIZED CONTROLLED-TRIAL; MYOCARDIAL-INFARCTION; SECONDARY PREVENTION; DEPRESSIVE SYMPTOMS; PROGRAM; HEALTH; EFFICACY; FAILURE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13698