The effect of a psychosocial intervention and quality of life after acute myocardial infarction

The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial

Carlos F. Mendes De Leon, Susan M. Czajkowski, Kenneth E. Freedland, Heejung Bang, Lynda H. Powell, Colin Wu, Matthew M. Burg, Vicki DiLillo, Gail Ironson, Harlan M. Krumholz, Pamela Mitchell, James A. Blumenthal

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

PURPOSE: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) clinical trial was designed to test whether intervening on depression or low perceived social support reduces mortality and reinfarction in patients with acute myocardial infarction (MI). This report analyzes the effect of the intervention on quality of life (QOL), which was an important secondary outcome. METHODS: ENRICHD was a randomized controlled clinical trial comparing a psychosocial intervention based on cognitive behavioral therapy to usual medical care in 2,481 patients from 8 clinical centers. Patients with acute MI were included if they met criteria for depression, low perceived social support, or both. QOL was assessed at the 6-month clinic visit in the first 1,296 patients. QOL measures included the Medical Outcomes Study Short Form summary measures of physical functioning (SF12-PCS) and mental functioning (SF12-MCS), a Life Satisfaction Scale (LSS), and a measure of overall QOL based on the ladder of life (LOL) technique. RESULTS: There were significant treatment differences on the SF12-MCS (difference 2.2, 95% confidence interval [CI] 1.2-3.2), the LSS (difference 1.0, 95% CI 0.5-1.5), and the LOL (difference 0.3, 95% CI 0.1-0.6), but not on the SF12-PCS (difference 0.8; 95% CI = -0.5-2.0). Effect sizes for the intervention on QOL outcomes were modest. CONCLUSIONS: Psychosocial interventions of limited duration confer modest QOL benefits in post-MI patients who are depressed or have low perceived social support. Interventions of longer duration or greater intensity may be required to produce more substantial improvements in QOL in these patients.

Original languageEnglish (US)
Pages (from-to)9-15
Number of pages7
JournalJournal of Cardiopulmonary Rehabilitation
Volume26
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

Fingerprint

Coronary Disease
Myocardial Infarction
Quality of Life
Clinical Trials
Social Support
Confidence Intervals
Depression
Cognitive Therapy
Ambulatory Care
Randomized Controlled Trials
Outcome Assessment (Health Care)
Mortality

Keywords

  • Acute myocardial infarction
  • Clinical trials
  • Psychosocial interventions
  • Quality of life

ASJC Scopus subject areas

  • Rehabilitation

Cite this

The effect of a psychosocial intervention and quality of life after acute myocardial infarction : The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial. / Mendes De Leon, Carlos F.; Czajkowski, Susan M.; Freedland, Kenneth E.; Bang, Heejung; Powell, Lynda H.; Wu, Colin; Burg, Matthew M.; DiLillo, Vicki; Ironson, Gail; Krumholz, Harlan M.; Mitchell, Pamela; Blumenthal, James A.

In: Journal of Cardiopulmonary Rehabilitation, Vol. 26, No. 1, 01.2006, p. 9-15.

Research output: Contribution to journalArticle

Mendes De Leon, CF, Czajkowski, SM, Freedland, KE, Bang, H, Powell, LH, Wu, C, Burg, MM, DiLillo, V, Ironson, G, Krumholz, HM, Mitchell, P & Blumenthal, JA 2006, 'The effect of a psychosocial intervention and quality of life after acute myocardial infarction: The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial', Journal of Cardiopulmonary Rehabilitation, vol. 26, no. 1, pp. 9-15. https://doi.org/10.1097/00008483-200601000-00002
Mendes De Leon, Carlos F. ; Czajkowski, Susan M. ; Freedland, Kenneth E. ; Bang, Heejung ; Powell, Lynda H. ; Wu, Colin ; Burg, Matthew M. ; DiLillo, Vicki ; Ironson, Gail ; Krumholz, Harlan M. ; Mitchell, Pamela ; Blumenthal, James A. / The effect of a psychosocial intervention and quality of life after acute myocardial infarction : The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial. In: Journal of Cardiopulmonary Rehabilitation. 2006 ; Vol. 26, No. 1. pp. 9-15.
@article{770b92051adc43ac802ed637c672bf62,
title = "The effect of a psychosocial intervention and quality of life after acute myocardial infarction: The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial",
abstract = "PURPOSE: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) clinical trial was designed to test whether intervening on depression or low perceived social support reduces mortality and reinfarction in patients with acute myocardial infarction (MI). This report analyzes the effect of the intervention on quality of life (QOL), which was an important secondary outcome. METHODS: ENRICHD was a randomized controlled clinical trial comparing a psychosocial intervention based on cognitive behavioral therapy to usual medical care in 2,481 patients from 8 clinical centers. Patients with acute MI were included if they met criteria for depression, low perceived social support, or both. QOL was assessed at the 6-month clinic visit in the first 1,296 patients. QOL measures included the Medical Outcomes Study Short Form summary measures of physical functioning (SF12-PCS) and mental functioning (SF12-MCS), a Life Satisfaction Scale (LSS), and a measure of overall QOL based on the ladder of life (LOL) technique. RESULTS: There were significant treatment differences on the SF12-MCS (difference 2.2, 95{\%} confidence interval [CI] 1.2-3.2), the LSS (difference 1.0, 95{\%} CI 0.5-1.5), and the LOL (difference 0.3, 95{\%} CI 0.1-0.6), but not on the SF12-PCS (difference 0.8; 95{\%} CI = -0.5-2.0). Effect sizes for the intervention on QOL outcomes were modest. CONCLUSIONS: Psychosocial interventions of limited duration confer modest QOL benefits in post-MI patients who are depressed or have low perceived social support. Interventions of longer duration or greater intensity may be required to produce more substantial improvements in QOL in these patients.",
keywords = "Acute myocardial infarction, Clinical trials, Psychosocial interventions, Quality of life",
author = "{Mendes De Leon}, {Carlos F.} and Czajkowski, {Susan M.} and Freedland, {Kenneth E.} and Heejung Bang and Powell, {Lynda H.} and Colin Wu and Burg, {Matthew M.} and Vicki DiLillo and Gail Ironson and Krumholz, {Harlan M.} and Pamela Mitchell and Blumenthal, {James A.}",
year = "2006",
month = "1",
doi = "10.1097/00008483-200601000-00002",
language = "English (US)",
volume = "26",
pages = "9--15",
journal = "Journal of Cardiopulmonary Rehabilitation and Prevention",
issn = "1932-7501",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - The effect of a psychosocial intervention and quality of life after acute myocardial infarction

T2 - The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial

AU - Mendes De Leon, Carlos F.

AU - Czajkowski, Susan M.

AU - Freedland, Kenneth E.

AU - Bang, Heejung

AU - Powell, Lynda H.

AU - Wu, Colin

AU - Burg, Matthew M.

AU - DiLillo, Vicki

AU - Ironson, Gail

AU - Krumholz, Harlan M.

AU - Mitchell, Pamela

AU - Blumenthal, James A.

PY - 2006/1

Y1 - 2006/1

N2 - PURPOSE: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) clinical trial was designed to test whether intervening on depression or low perceived social support reduces mortality and reinfarction in patients with acute myocardial infarction (MI). This report analyzes the effect of the intervention on quality of life (QOL), which was an important secondary outcome. METHODS: ENRICHD was a randomized controlled clinical trial comparing a psychosocial intervention based on cognitive behavioral therapy to usual medical care in 2,481 patients from 8 clinical centers. Patients with acute MI were included if they met criteria for depression, low perceived social support, or both. QOL was assessed at the 6-month clinic visit in the first 1,296 patients. QOL measures included the Medical Outcomes Study Short Form summary measures of physical functioning (SF12-PCS) and mental functioning (SF12-MCS), a Life Satisfaction Scale (LSS), and a measure of overall QOL based on the ladder of life (LOL) technique. RESULTS: There were significant treatment differences on the SF12-MCS (difference 2.2, 95% confidence interval [CI] 1.2-3.2), the LSS (difference 1.0, 95% CI 0.5-1.5), and the LOL (difference 0.3, 95% CI 0.1-0.6), but not on the SF12-PCS (difference 0.8; 95% CI = -0.5-2.0). Effect sizes for the intervention on QOL outcomes were modest. CONCLUSIONS: Psychosocial interventions of limited duration confer modest QOL benefits in post-MI patients who are depressed or have low perceived social support. Interventions of longer duration or greater intensity may be required to produce more substantial improvements in QOL in these patients.

AB - PURPOSE: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) clinical trial was designed to test whether intervening on depression or low perceived social support reduces mortality and reinfarction in patients with acute myocardial infarction (MI). This report analyzes the effect of the intervention on quality of life (QOL), which was an important secondary outcome. METHODS: ENRICHD was a randomized controlled clinical trial comparing a psychosocial intervention based on cognitive behavioral therapy to usual medical care in 2,481 patients from 8 clinical centers. Patients with acute MI were included if they met criteria for depression, low perceived social support, or both. QOL was assessed at the 6-month clinic visit in the first 1,296 patients. QOL measures included the Medical Outcomes Study Short Form summary measures of physical functioning (SF12-PCS) and mental functioning (SF12-MCS), a Life Satisfaction Scale (LSS), and a measure of overall QOL based on the ladder of life (LOL) technique. RESULTS: There were significant treatment differences on the SF12-MCS (difference 2.2, 95% confidence interval [CI] 1.2-3.2), the LSS (difference 1.0, 95% CI 0.5-1.5), and the LOL (difference 0.3, 95% CI 0.1-0.6), but not on the SF12-PCS (difference 0.8; 95% CI = -0.5-2.0). Effect sizes for the intervention on QOL outcomes were modest. CONCLUSIONS: Psychosocial interventions of limited duration confer modest QOL benefits in post-MI patients who are depressed or have low perceived social support. Interventions of longer duration or greater intensity may be required to produce more substantial improvements in QOL in these patients.

KW - Acute myocardial infarction

KW - Clinical trials

KW - Psychosocial interventions

KW - Quality of life

UR - http://www.scopus.com/inward/record.url?scp=33745789280&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745789280&partnerID=8YFLogxK

U2 - 10.1097/00008483-200601000-00002

DO - 10.1097/00008483-200601000-00002

M3 - Article

VL - 26

SP - 9

EP - 15

JO - Journal of Cardiopulmonary Rehabilitation and Prevention

JF - Journal of Cardiopulmonary Rehabilitation and Prevention

SN - 1932-7501

IS - 1

ER -