Key result
Integrating psychological interventions into cardiac rehabilitation reduces depression and anxiety despite low overall uptake.
Why the study?
Cardiac rehabilitation is central to cardiovascular care but remains underused, and this work provides an overview of the dual role of psychological factors as determinants of engagement and long-term behavior change and as treatment targets.
Psychological factors must be continually assessed and targeted throughout the cardiac rehabilitation pathway, rather than only at intake, to improve program engagement, sustain long-term lifestyle changes, and optimize patient recovery.
Integrating psychological interventions into cardiac rehabilitation may reduce depression and anxiety; leaves open scalable strategies to boost participation beyond current low rates.
To provide an overview of the dual role of psychological factors: as determinants of cardiac rehabilitation (CR) engagement and long-term behavior change, and as consequences and treatment targets. CR is central to cardiovascular care but remains underused. Beyond systemic and logistical barriers, psychological factors influence whether patients participate in and complete CR and maintain a healthy lifestyle post-CR. Psychological distress is common in patients eligible for CR and negatively affects quality of life and prognosis. Without addressing these factors, CR jeopardizes remaining an effective but underused intervention which full potential is not realized. Psychological factors should be understood both as barriers to CR participation, completion, and long-term benefit, and as actionable targets to improve these outcomes. They should therefore not be limited to intake risk screening but assessed and acted upon across the CR pathway to support engagement and enhance sustained behavior change and patient-centered recovery.
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Hafkamp et al. (2026) conducted a review in Cardiovascular disease (including coronary heart disease, heart failure, and atrial fibrillation) eligible for cardiac rehabilitation. Cardiac rehabilitation and integrated psychological interventions was evaluated. Psychological interventions integrated with cardiac rehabilitation reduce depression (SMD -0.36) and anxiety (SMD -0.57) while addressing barriers to participation in only 20-30% of eligible patients.
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