The Support, Education, and Research in Chronic Heart Failure Study (SEARCH): a mindfulness-based psychoeducational
Martin J Sullivan1, Laura Wood, Jennifer Terry
1Institute for Health and Wellness, Chapel Hill, NC, USA.
Insights
A mindfulness-based intervention improved symptoms and reduced depression in chronic heart failure (CHF) patients. While anxiety and depression benefits lessened at one year, CHF symptoms remained significantly better.
Area of Science:
- Cardiology
- Psychology
- Public Health
Background:
- Psychosocial factors, including depression, are significant risk factors for adverse events in patients with chronic heart failure (CHF).
- Limited large-scale clinical trials have assessed the efficacy of psychosocial interventions for managing these factors in CHF patients.
- The Support, Education, and Research in Chronic Heart Failure (SEARCH) study aimed to address this gap.
Purpose of the Study:
- To evaluate the impact of a mindfulness-based psychoeducational intervention on clinical outcomes, depression, and quality of life in patients with CHF.
- To determine if psychosocial interventions can effectively reduce risk factors and improve well-being in this population.
Main Methods:
- A prospective cohort study involving 208 adults with CHF (left ventricular ejection fraction ≤40%).
- Participants were randomized into treatment or control groups, with follow-up at 3, 6, and 12 months.
- The 8-week intervention included weekly sessions on mindfulness meditation, coping skills, and support group discussions.
Main Results:
- The intervention group showed significant reductions in anxiety (Profile of Mood States, P = .003) and depression (Center of Epidemiology - Depression, P = .05) compared to controls.
- Patients receiving the intervention reported improved symptoms (Kansas City Cardiomyopathy Questionnaire symptom scale, P = .033) and clinical scores (P = .024) over time.
- No significant treatment effects were observed for death or rehospitalization rates at the 1-year follow-up.
Conclusions:
- An 8-week mindfulness-based psychoeducational intervention effectively reduced anxiety and depression in CHF patients, though these effects diminished by 1 year.
- The intervention resulted in significantly improved CHF symptoms at 12 months compared to the control group.
- These findings suggest that such interventions may be a valuable component of optimal CHF therapy.
Background:
The Support, Education, and Research in Chronic Heart Failure (SEARCH) study was designed to assess the impact of a mindfulness-based psychoeducational intervention on clinical outcomes, depression, and quality of life in patients with chronic heart failure (CHF). Although research has shown that psychosocial factors including depression are important risk factors for adverse events in patients with CHF, no large clinical trials have investigated the efficacy of psychosocial interventions to reduce these factors in this population.
Methods:
This was a prospective cohort study of 208 adults with left ventricular ejection fraction < or =40% and CHF geographically assigned to treatment or control groups with follow-up at 3, 6, and 12 months. Treatment groups met weekly for 8 consecutive weeks for training in mindfulness meditation, coping skills, and support group discussion.
Results:
Subjects had a mean age of 61 years, left ventricular ejection fraction 26%, and median New York Heart Association class II. The majority were treated with angiotensin-converting enzyme inhibitors (80%) and beta-blockers (86%). At baseline, patients in the treatment group had more severe CHF with higher New York Heart Association class (P = .0209) and more severe psychological distress (Center of Epidemiology - Depression, Profile of Mood States; P < .05). When compared with controls, treatment resulted in lower anxiety (Profile of Mood States, P = .003), depression (Center of Epidemiology - Depression, P = .05), improved symptoms (Kansas City Cardiomyopathy Questionnaire symptom scale, P = .033) and clinical scores (Kansas City Cardiomyopathy Questionnaire clinical score, P = .024) over time. There were no treatment effects on death/rehospitalization at 1 year.
Conclusions:
An 8-week mindfulness-based psychoeducational intervention reduced anxiety and depression; this effect was attenuated at 1 year. Importantly, the intervention led to significantly better symptoms of CHF at 12 months compared to control subjects. Our results suggest that interventions of this type might have a role in optimal therapy for CHF.
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