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 language | English (US) |
|---|---|
| Pages (from-to) | 9-15 |
| Number of pages | 7 |
| Journal | Journal of Cardiopulmonary Rehabilitation |
| Volume | 26 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2006 |
| Externally published | Yes |
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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 journal › Article
}
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
C2 - 16617220
AN - SCOPUS:33745789280
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 -