title: Lifestyle modification programmes for patients with coronary heart disease: a systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Lifestyle modification programmes for coronary heart disease patients have been shown to effectively improve risk factors and related health behaviours, quality of life, reincidence, and mortality. However, improvements in routine cardiac care over the recent years may offset the incremental benefit associated with older programmes.
  
  
  OBJECTIVE
  To determine the efficacy of lifestyle modification programmes for coronary heart disease patients developed over the last decade (1999-2009) by means of a systematic review and meta-analysis.
  
  
  RESULTS
  The study included 23 trials (involving 11,085 randomized patients). Lifestyle modification programmes were associated with reduced all-cause mortality (summary OR 1.34, 95% CI 1.10-1.64), cardiac mortality (summary OR 1.48, 95% CI 1.17-1.88), and cardiac readmissions and non-fatal reinfarctions (summary OR 1.35, 95% CI 1.17-1.55). Furthermore, lifestyle modification programmes positively affected risk factors and related lifestyle behaviours at posttreatment (M = 10.2 months), and some of these benefits were maintained at long-term follow up (M = 33.7 months). Improvements in dietary and exercise behaviour were greater for programmes incorporating all four self-regulation techniques (i.e. goal setting, self-monitoring, planning, and feedback techniques) compared to interventions that included none of these techniques.
  
  
  CONCLUSIONS
  The evidence summarized in this meta-analysis confirms the benefits of lifestyle modification programmes - over and above benefits achieved by routine clinical care alone.
authors.affiliation: Department of Health Psychology, Leiden University, Leiden, The Netherlands. VJanssen@fsw.leidenuniv.nl
authors.forename: Veronica
authors.initials: V
authors.lastname: Janssen
authors.forename: Véronique
authors.initials: V
authors.lastname: De Gucht
authors.forename: Elise
authors.initials: E
authors.lastname: Dusseldorp
authors.forename: Stan
authors.initials: S
authors.lastname: Maes
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018450:Disease Progression; D019317:Evidence-Based Medicine; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome