Article

Recently, we found a telephone-delivered secondary prevention
programme using health coaching ('ProActive Heart') to be effective in improving
a range of key behavioural outcomes for myocardial infarction (MI) patients. What
remains unclear, however, is the extent to which these treatment effects
translate to important psychological outcomes such as depression and anxiety
outcomes, an issue of clinical significance due to the substantial proportion of
MI patients who experience depression and anxiety. The objective of the study was
to investigate, as a secondary hypothesis of a larger trial, the effects of a
telephone-delivered health coaching programme on depression and anxiety outcomes
of MI patients. DESIGN: Two-arm, parallel-group, randomized, controlled design
with six-months outcomes. METHODS: Patients admitted to one of two tertiary
hospitals in Brisbane, Australia following MI were assessed for eligibility. Four
hundred and thirty patients were recruited and randomly assigned to usual care or
an intervention group comprising up to 10 telephone-delivered 'health coaching'
sessions (ProActive Heart). Regression analysis compared Hospital Anxiety and
Depression Scale scores of completing participants at six months (intervention: n
= 141 versus usual care: n = 156). RESULTS: The intervention yielded reductions
in anxiety at follow-up (mean difference = -0.7, 95% confidence
interval=-1.4,-0.02) compared with usual care. A similar pattern was observed in
mean depression scores but was not statistically significant. CONCLUSIONS: The
ProActive Heart programme effectively improves anxiety outcomes of patients
following myocardial infarction. If combined with psychological-specific
treatment, this programme could impact anxiety of greater intensity in a
clinically meaningful way.

Langue : ANGLAIS