Abstract
The purpose of this systematic review was to examine the effectiveness of cognitive behavior therapy (CBT) in minimizing the depressive symptoms and improving quality of life in heart failure (HF) patients with depression. This systematic review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of effectiveness evidence. This review only considered randomized controlled trial, assessing the effectiveness of CBT as a treatment for depression in adults (aged above 18) with HF, compared with usual care, which may include medications. This systematic review includes five RCTs involving 379 HF patients with depression (CBT = 192; Control = 187). Two RCTs compared CBT versus usual care using BDI, and no statistically significant differences were observed in reduction of depression after three months of the intervention (MD ?0.92, 95% CI ?1.89 to ?0.05) (p = 0.06). However, a significant difference of depression level was identified between CBT and control groups in a meta-analysis of two RCTs after 6-months of intervention measured by Hamilton Depression Scale (HAM-D) (MD ?3.34, 95% CI ?5.00 to ?1.68) (p = 0.0001) with moderate heterogeneity (I2 = 43%). Quality of life was assessed at three months between intervening groups undergoing CBT and the control group with usual care in two RCTs. A statistically significant improvement was observed in the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in the CBT group compared with usual care (MD ?9.44, 95% CI ?13.02 to ?5.87) (p < 0.0001). The key finding of this review is that CBT is likely to be helpful in improving the depressive symptoms and quality of life in HF patients with depression. Moreover, long-term continued CBT sessions may help in minimizing the depression level and improving the QoL.
Highlights
Heart Failure (HF) is a complex clinical syndrome that results from a structural/functional impairment of one or both ventricles, resulting in the reduced ventricular ejection of blood from the ventricle in systole heart failure (HF) [1]
The key finding of this review is that cognitive behavior therapy (CBT) is likely to be helpful in improving the depressive symptoms and quality of life in HF patients with depression
Long-term continued CBT sessions may help in minimizing the depression level and improving the Quality of life (QoL)
Summary
Heart Failure (HF) is a complex clinical syndrome that results from a structural/functional impairment of one or both ventricles, resulting in the reduced ventricular ejection of blood from the ventricle in systole HF [1]. Current estimates suggest that approximately 26 million people worldwide live with chronic HF [1]. In Australia, it is estimated that 30,000 people receive a diagnosis of chronic HF each year [2] and prevalence of HF in Australia is similar to that of other industrialized countries, ranging between 1% - 2% [3] [4]. HF comes with multiple burdens to the individual, health sectors and the economy. One of the burdens that emerge is the high cases of hospital admissions [6]. HF accounts for about 1% - 4% of all hospital admissions in economically developed countries [4], and the economic cost of HF in Australia is estimated to be more than $1 billion per annum [2]. Anxiety, and depression are common, and work, travel and day-to-day social and leisure activities are difficult for those with breathlessness and extreme fatigue [2]
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