Psychological Interventions for Patients with Coronary Heart Disease and Their Partners: A Systematic Review

OBJECTIVES: Despite evidence that patients with coronary heart disease (CHD) and their partners report significant psychological distress, and suggestions that involving partners in interventions alleviates such distress, no systematic reviews have examined this. The objective of this study was to systematically review evidence on the effectiveness of psychological interventions for patients with CHD and their partners. METHODS: CENTRAL, Medline, EMBASE, CINAHL and PsycINFO databases were searched through October 2012. Randomized controlled trials evaluating psychological interventions for patients with CHD and their partners were included. Selection of studies, study appraisal, data extraction and analysis were undertaken using standard methods. RESULTS: Seven studies comprising 673 dyads (patient and partner) were included. Psychological interventions result in modest improvements in patients' health-related quality of life, blood pressure, knowledge of disease and treatment, and satisfaction with care, and in partners' anxiety, knowledge and satisfaction. There was a non-significant trend for improvements in anxiety for patients, and depressive symptoms for both patients and partners. There was no evidence of a significant effect on mortality, morbidity or other cardiovascular risk factors for patients, or social support for patients and partners. CONCLUSIONS: Psychological interventions for patients with CHD and their partners were found to improve health-related quality of life, blood pressure, knowledge, and satisfaction with care for patients, and anxiety, knowledge, and satisfaction with care for partners. However, as the overall quality of the evidence was low, these results should be interpreted with caution.