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Abstract
BackgroundCardiac rehabilitation is offered to individuals after cardiac events to aid recovery and reduce the likelihood of further cardiac illness. However, patient participation remains suboptimal and the provision of high quality care to an expanding population of patients with chronic heart conditions is becoming increasingly difficult. A systematic review and meta-analysis was conducted to determine the effect of telephone support interventions compared with standard post-discharge care on coronary artery disease patient outcomes.MethodsThe Cochrane Library, MEDLINE, EMBASE, and CINAHL were searched and randomized controlled trials that directly compared telephone interventions with standard post-discharge care in adults following a myocardial infarction or a revascularization procedure were included. Study selection, data extraction and quality assessment were completed independently by two reviewers. Where appropriate, outcome data were combined and analyzed using a random effects model. For each dichotomous outcome, odds ratios (OR) and 95% confidence intervals (CI) were derived for each outcome. For continuous outcomes, weighted mean differences (WMD) and standardized mean differences (SMD) and 95% CI were calculated.Results26 studies met the inclusion criteria. No difference was observed in mortality between the telephone group and the group receiving standard care OR 1.12 (0.71, 1.77). The intervention was significantly associated with fewer hospitalizations than the comparison group OR 0.62 (0.40, 0.97). Significantly more participants in the telephone group stopped smoking OR 1.32 (1.07, 1.62); had lower systolic blood pressure WMD −0.22 (−0.40, −0.04); lower depression scores SMD −0.10 (−0.21, −0.00); and lower anxiety scores SMD −0.14 (−0.24, −0.04). However, no significant difference was observed for low-density lipoprotein levels WMD −0.10 (−0.23, 0.03).ConclusionsCompared to standard post-discharge care, regular telephone support interventions may help reduce feelings of anxiety and depression as well as, improve systolic blood pressure control and the likelihood of smoking cessation.
Highlights
Cardiac rehabilitation (CR) is offered to individuals after cardiac events to aid recovery and reduce the likelihood of further cardiac illness
More basic telephone support interventions have been adapted for use in coronary artery disease (CAD) patient populations CAD is one of the most common forms of heart disease that results from an impedance or blockage of one or more arteries that supply blood to the heart [11,12]
Further research is needed to examine the cost-effectiveness of this intervention as it compares to the current standard of postdischarge care. The effectiveness of this simple telephone intervention is of relevance given that most cardiac rehabilitation programs involve one or more of the following: routine monitoring, counseling, and educating
Summary
Cardiac rehabilitation (CR) is offered to individuals after cardiac events to aid recovery and reduce the likelihood of further cardiac illness They have been previously shown to improve physical health as well as decrease subsequent morbidity and mortality through exercise, education, behavior change, counseling and other strategies aimed at targeting traditional risk factors for cardiovascular disease [1,2,3,4,5,6]. Some evidence suggests that interventions involving motivational communications delivered through letters, telephone calls and home visits may increase the uptake of cardiac rehabilitation [8].This offers promise as the provision of high quality care to an expanding population of older patients with chronic heart conditions becomes increasingly difficult. A systematic review and meta-analysis was conducted to determine the effect of telephone support interventions compared with standard postdischarge care on coronary artery disease patient outcomes
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