Home-based secondary prevention programs may help reduce anxiety in individuals with coronary artery disease.

McClure T, Haykowsky MJ, Schopflocher D et al.  Home-based secondary prevention programs for patients with coronary artery disease: A meta-analysis of effects on anxiety  J Cardiopulm Rehabil Prev. 2013; 33(2):59-67

Review question

Do home-based prevention programs lower anxiety among individuals with coronary heart disease?

Background

Many people with coronary heart disease experience anxiety, which can affect their quality of life and daily living.  Secondary prevention programs (such as rehabilitation) can improve life expectancy, quality of life and heart disease risk factors in patients with coronary heart disease, but little is known about whether these programs help to ease patient anxiety.  This review focused on home-based programs, since patients are more likely to participate at home, rather than at centre-based programs.

How the review was done

This is a summary of 8 single studies, which included a total of 3011 participants ranging in age from 56 to 67 years). One study included only women; the majority of participants in the other studies were men (60 – 82%).

The studies used anxiety measurement tools to assess whether home-based secondary prevention programs affected the anxiety levels of people with established heart disease.  All of the programs were led by nurses with special training in cardiac disease.  The quality of included studies was moderate to low.

What the researchers found

Home-based secondary prevention programs were associated with small reductions in anxiety compared to usual care or centre-based cardiac rehabilitation.  The most effective programs provided manuals or other printed material about risk factors and guidance on health promotion practices (exercise, diet, and psychosocial well-being), as well as follow-up phone calls or home visits from a health professional.  Since women and men may have different psychological needs, it would be helpful for future studies to examine whether gender makes a difference in how people respond to this type of support.

Conclusion

Comprehensive cardiac rehabilitation programs delivered in the home may help reduce anxiety among individuals with heart disease.