A meta-analysis of controlled trials of cardiac patient education.

Because of the heavy burden of morbidity and mortality exacted by coronary heart disease and the role of behavior in secondary prevention, patient education is a crucial part of cardiac care. Yet evaluations of such programs have not been synthesized to assess the average effects nor which program characteristics have greatest impact. This study used the quantitative methods of meta-analysis to answer these questions, with 28 controlled studies measuring behavioral and clinical outcomes. Results indicate that cardiac patient education programs have demonstrated a measurable impact on blood pressure, mortality, exercise, and diet, other parameters are positively affected, although less consistently. Type of communication channel did not influence outcome; adherence to educational principles did. Thus, cardiac programs should use reinforcement, give feedback, offer opportunity for individualization, facilitate behavior change through skills and resources, and be relevant to patients' needs and abilities.