title: Telephone-delivered health coaching improves anxiety outcomes after myocardial infarction: the 'ProActive Heart' trial.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
authors.affiliation: Barwon Psychiatric Research Unit, Deakin University, Geelong, Australia.
authors.forename: Adrienne
authors.initials: A
authors.lastname: O'Neil
authors.forename: Anna L
authors.initials: AL
authors.lastname: Hawkes
authors.forename: John J
authors.initials: JJ
authors.lastname: Atherton
authors.forename: Tania A
authors.initials: TA
authors.lastname: Patrao
authors.forename: Kristy
authors.initials: K
authors.lastname: Sanderson
authors.forename: Rory
authors.initials: R
authors.lastname: Wolfe
authors.forename: C Barr
authors.initials: CB
authors.lastname: Taylor
authors.forename: Brian
authors.initials: B
authors.lastname: Oldenburg
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011793:Queensland; D055502:Secondary Prevention / Q000295:instrumentation*; D017216:Telemedicine / Q000295:instrumentation*; D013689:Telephone; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome