Examining the effectiveness of psychosocial interventions for patients with a cardiac implantable electronic device: A systematic review and meta-analysis.
Mitchell Nicmanis, Olivia Arcangeli, Anna Chur-Hansen, Melissa Oxlad
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引用次数: 0
Abstract
Background: Despite the well-established physiological and survival benefits of cardiac implantable electronic devices, evidence highlights the psychosocial distress experienced by patients.
Objective: This systematic review examined the effectiveness of psychosocial interventions for improving psychosocial outcomes of patients with a cardiac implantable electronic device.
Methods: Eight databases (CINAHL, Cochrane Library, Embase, Emcare, PsycINFO, PubMed, Scopus, and Web of Science) were searched. Two reviewers screened all records. Methodological quality was assessed using the QualSyst checklist. Intervention effects and attrition were evaluated using random-effects meta-analyses, supported by a narrative synthesis of studies not included in the meta-analysis.
Results: Of the 9631 records screened, 34 articles representing 26 independent studies (3370 participants; 2952 with an implantable cardioverter-defibrillator, 418 with a pacemaker) were included. The attrition rate was 12.1% (95%CI 0.08 to 0.18), lower in education-based interventions (8.6%) than psychotherapy-based ones (23.5%). Psychosocial interventions significantly reduced anxiety for patients with an implantable cardioverter-defibrillator compared to controls, with a small to medium effect following intervention (Hedges' g = -0.30, 95%CI -0.51 to -0.09); moderator analysis indicated that psychotherapy based on cognitive-behavioral principles and face-to-face interventions were more effective. No effects were found for cardiac-specific anxiety, depression, or quality of life in the 12 studies available in the meta-analysis. The narrative synthesis supported these findings. Only four studies considered patients with a pacemaker.
Conclusion: Psychosocial interventions appear promising for improving the psychosocial outcomes of these patients. Further robust trials are needed to determine the effectiveness of these interventions, the patients who benefit most, and differences in outcomes.
期刊介绍：
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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