A systematic review of psychoeducational intervention trials for the management of chronic stable angina

BACKGROUND: Chronic stable angina (CSA) is a cardinal symptom of coronary artery disease and has a major impact on health-related quality of life (HRQOL). There are few data on the effectiveness of psychoeducational interventions for CSA patients that target HRQOL-related outcomes. AIM: To determine the effectiveness of psychoeducational interventions for CSA management based on the best available evidence. METHODS: A systematic review of randomized controlled trials (RCTs) testing the effects of psychoeducational interventions on angina symptoms, angina symptom-related distress, and physical functioning was conducted. Four primary studies (1994-97) were included that had (a) specified treatment and control conditions, (b) participants with anigna class I-III (Canadian Cardiovascular Society) and (c) psychoeducational interventions. These studies were reviewed for methodological rigour. A pooled common effect could not be determined because of heterogeneity of outcomes, measures and analyses. RESULTS: While positive effects were reported, methodological problems with respect to sampling, randomization, controls and measurement precluded generalization. CONCLUSION: The effectiveness of psychoeducation interventions for improving angina outcomes is inconclusive. Future RCTs of psychoeducational programmes require methodologically robust methods to reduce biases and random error, and to enhance the generalizability of findings for CSA management.