Lampros Samartzis1, Stavros Dimopoulos, Maria Tziongourou, Serafim Nanas. 1. Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evgenidio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Abstract
BACKGROUND: Patients with chronic heart failure (CHF) usually experience poor quality of life (QoL). Psychosocial interventions tend to affect QoL in CHF. The aim of this study was to explore: 1) the effectiveness of psychosocial interventions on patients' QoL; 2) the magnitude of this effect; and 3) factors that appear to moderate the reported effect on QoL. METHODS AND RESULTS: Meta-analysis of the data of 1,074 intervention patients and 1,106 control patients from 16 randomized controlled trials (RCTs) that reported QoL measures in treatment and control groups before and after a psychosocial intervention. Subgroup analyses were conducted between: 1) face-to-face versus telephone interventions; 2) interventions that included only patients versus those that included patients and their caregivers; and 3) interventions conducted by a physician and a nurse only, versus those conducted by a multidisciplinary team. Psychosocial interventions improved QoL of CHF patients (standardized mean difference 0.46, confidence interval [CI] 0.19-0.72; P < .001). Face-to-face interventions showed greater QoL improvement compared with telephone interventions (χ(2) = 5.73; df = 1; P < .02). Interventions that included caregivers did not appear to be significantly more effective (χ(2) = 1.12; df = 1; P > .29). A trend was found for multidisciplinary team approaches being more effective compared with nonmultidisciplinary approaches (χ(2) = 1.96; df = 1; P = .16). CONCLUSIONS: A significant overall QoL improvement emerged after conducting psychosocial interventions with CHF patients. Interventions based on a face-to-face approach showed greater benefit for patients' QoL compared with telephone-based approaches. No significant advantage was found for interventions conducted by a multidisciplinary team compared with a physician and nurse approach, or for psychosocial interventions which included patients' caregivers compared with patient-only approaches.
BACKGROUND:Patients with chronic heart failure (CHF) usually experience poor quality of life (QoL). Psychosocial interventions tend to affect QoL in CHF. The aim of this study was to explore: 1) the effectiveness of psychosocial interventions on patients' QoL; 2) the magnitude of this effect; and 3) factors that appear to moderate the reported effect on QoL. METHODS AND RESULTS: Meta-analysis of the data of 1,074 intervention patients and 1,106 control patients from 16 randomized controlled trials (RCTs) that reported QoL measures in treatment and control groups before and after a psychosocial intervention. Subgroup analyses were conducted between: 1) face-to-face versus telephone interventions; 2) interventions that included only patients versus those that included patients and their caregivers; and 3) interventions conducted by a physician and a nurse only, versus those conducted by a multidisciplinary team. Psychosocial interventions improved QoL of CHFpatients (standardized mean difference 0.46, confidence interval [CI] 0.19-0.72; P < .001). Face-to-face interventions showed greater QoL improvement compared with telephone interventions (χ(2) = 5.73; df = 1; P < .02). Interventions that included caregivers did not appear to be significantly more effective (χ(2) = 1.12; df = 1; P > .29). A trend was found for multidisciplinary team approaches being more effective compared with nonmultidisciplinary approaches (χ(2) = 1.96; df = 1; P = .16). CONCLUSIONS: A significant overall QoL improvement emerged after conducting psychosocial interventions with CHFpatients. Interventions based on a face-to-face approach showed greater benefit for patients' QoL compared with telephone-based approaches. No significant advantage was found for interventions conducted by a multidisciplinary team compared with a physician and nurse approach, or for psychosocial interventions which included patients' caregivers compared with patient-only approaches.
Authors: Pavlos G Myserlis; Antonia Malli; Dimitrios K Kalaitzoglou; Grigorios Kalaitzidis; Michael Miligkos; Damianos G Kokkinidis; Andreas P Kalogeropoulos Journal: Heart Fail Rev Date: 2017-01 Impact factor: 4.214
Authors: Phillip J Tully; Deborah A Turnbull; John D Horowitz; John F Beltrame; Terina Selkow; Bernhard T Baune; Elizabeth Markwick; Shannon Sauer-Zavala; Harald Baumeister; Suzanne Cosh; Gary A Wittert Journal: Trials Date: 2016-01-11 Impact factor: 2.279