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Dagens #fsvoversigt:
The effect of telephone support interventions on coronary artery disease (CAD)
patient outcomes during cardiac rehabilitation: a systematic review and
meta-analysis.
PLoS One. 2014;9(5):e96581
Authors: Kotb A, Hsieh S, Wells GA
Abstract
BACKGROUND: Cardiac 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.
METHODS: The 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.
RESULTS: 26 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).
CONCLUSIONS: Compared 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.
PMID: 24798429 [PubMed - indexed for MEDLINE]
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
(http://www.ncbi.nlm.nih.gov/About/disclaimer.html).
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Se abstractet i PubMed: http://evidens.link/1OffLu5
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