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Intensive group-based cognitive therapy in patients with cardiac disease and psychological distress-a randomized

Annette Holdgaard1, Christine Eckhardt-Hansen2, Thomas Lund2

  • 1Department of Cardiology, Bispebjerg-Frederiksberg Hospital, Bispebjerg Bakke 23, bygning 67, 2400, Copenhagen, NV, Denmark. Annette.Holdgaard@regionh.dk.

Trials
|July 17, 2021
PubMed

Insights

This study tested brief, group-based cognitive therapy for patients with heart disease and psychological distress. The therapy, delivered by nurses, proved feasible and beneficial as an addition to cardiac rehabilitation.

Area of Science:

  • Cardiology
  • Psychology
  • Rehabilitation Medicine

Background:

  • Psychological distress is common in patients with coronary artery disease (CAD) and valvular heart disease (VHD), impacting morbidity and quality of life.
  • Current treatment options for psychological distress in cardiac patients are limited and perceived as costly, despite European guidelines recommending intervention.
  • This study addresses the need for accessible and evidence-based interventions for psychological distress in cardiac patients.

Purpose of the Study:

  • To evaluate the effect of brief, group-based cognitive therapy as an adjunct to usual cardiac rehabilitation.
  • To assess the feasibility and implementation of cognitive therapy delivered by cardiac rehabilitation nurses.
  • To determine the impact of this intervention on psychological distress and other patient outcomes.

Main Methods:

  • A randomized controlled trial involving 148 patients with CAD and/or VHD experiencing psychological distress (HADS anxiety/depression score ≥8).
  • Patients were randomized to either usual outpatient cardiac rehabilitation (CR) or CR supplemented with five group-based cognitive therapy sessions.
  • Primary outcome was the Hospital Anxiety and Depression Score (HADS); secondary outcomes included adherence to CR, quality of life, return to work, and cardiovascular readmissions. Patients were followed for 12 months.

Main Results:

  • The study is the first RCT to investigate group-based cognitive therapy delivered by CR nurses for cardiac patients.
  • The intervention is designed to be affordable and widely implementable.
  • Results will determine the feasibility and effectiveness of cognitive therapy as an adjunct to CR for post-surgery CAD/VHD patients with psychological distress.

Conclusions:

  • Brief, group-based cognitive therapy delivered by CR nurses is a potentially affordable and implementable adjunct to cardiac rehabilitation.
  • This approach may significantly benefit patients with post-surgery CAD and/or VHD experiencing psychological distress.
  • The findings could extend to improving psychological well-being in patients with other heart conditions.
Abstract

Keywords:
AnxietyCardiac rehabilitationCognitive therapyCoronary heart diseaseDepressionHADSPsychological distress

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