title: Home-based secondary prevention programs for patients with coronary artery disease: a meta-analysis of effects on anxiety.
abstract: OBJECTIVE
  Anxiety is common among patients with coronary artery disease (CAD). Despite the benefits of home-based CAD prevention interventions on quality of life and atherosclerotic risk factors, the efficacy of home-based programs in reducing patient anxiety is unknown.
  
  
  METHODS
  We performed a systematic review and meta-analysis of all randomized trials that examined the effects of home-based interventions on anxiety reduction in patients with CAD published in 18 databases until December 2009. Analyses were based on changes in the standardized mean difference between treatment groups.
  
  
  RESULTS
  Eight trials containing intervention means and standard deviations on anxiety were reviewed. Overall quality of the trials was low to moderate. Compared with usual care or center-based cardiac rehabilitation, home-based interventions had a small but significant effect in reducing anxiety (total effect size: -0.13; 95% CI: -0.20 to -0.06; P < .001; I = 66%).
  
  
  CONCLUSIONS
  This meta-analysis provides evidence that home-based secondary prevention programs are effective in reducing anxiety level in CAD patients. However, because of the limited number of trials available and high degrees of heterogeneity in the data, further research needs to be done to provide a definitive answer on the benefits of home-based programs on anxiety management in CAD patients.
authors: Faculty of Nursing, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors: Todd
authors: T
authors: McClure
authors: Mark J
authors: MJ
authors: Haykowsky
authors: Don
authors: D
authors: Schopflocher
authors: Zoe Y
authors: ZY
authors: Hsu
authors: Alexander M
authors: AM
authors: Clark
mesh_terms: D000368:Aged; D001007:Anxiety / Q000517:prevention & control*; D003324:Coronary Artery Disease / Q000523:psychology*; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011788:Quality of Life; D012047:Rehabilitation Centers; D055502:Secondary Prevention / Q000379:methods*