title: Effect of psychosocial interventions on quality of life in patients with chronic heart failure: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Patients with chronic heart failure (CHF) usually experience poor quality of life (QoL). Psychosocial interventions tend to affect QoL in CHF. The aim of this study was to explore: 1) the effectiveness of psychosocial interventions on patients' QoL; 2) the magnitude of this effect; and 3) factors that appear to moderate the reported effect on QoL.
  
  
  RESULTS
  Meta-analysis of the data of 1,074 intervention patients and 1,106 control patients from 16 randomized controlled trials (RCTs) that reported QoL measures in treatment and control groups before and after a psychosocial intervention. Subgroup analyses were conducted between: 1) face-to-face versus telephone interventions; 2) interventions that included only patients versus those that included patients and their caregivers; and 3) interventions conducted by a physician and a nurse only, versus those conducted by a multidisciplinary team. Psychosocial interventions improved QoL of CHF patients (standardized mean difference 0.46, confidence interval [CI] 0.19-0.72; P < .001). Face-to-face interventions showed greater QoL improvement compared with telephone interventions (χ(2) = 5.73; df = 1; P < .02). Interventions that included caregivers did not appear to be significantly more effective (χ(2) = 1.12; df = 1; P > .29). A trend was found for multidisciplinary team approaches being more effective compared with nonmultidisciplinary approaches (χ(2) = 1.96; df = 1; P = .16).
  
  
  CONCLUSIONS
  A significant overall QoL improvement emerged after conducting psychosocial interventions with CHF patients. Interventions based on a face-to-face approach showed greater benefit for patients' QoL compared with telephone-based approaches. No significant advantage was found for interventions conducted by a multidisciplinary team compared with a physician and nurse approach, or for psychosocial interventions which included patients' caregivers compared with patient-only approaches.
authors: Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evgenidio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors: Lampros
authors: L
authors: Samartzis
authors: Stavros
authors: S
authors: Dimopoulos
authors: Maria
authors: M
authors: Tziongourou
authors: Serafim
authors: S
authors: Nanas
mesh_terms: D002908:Chronic Disease; D061345:Early Medical Intervention / Q000379:methods / Q000639:trends*; D006333:Heart Failure / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D011788:Quality of Life / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000639:trends; D012944:Social Support; D016896:Treatment Outcome