[The effect of psychosocial rehabilitation after acute myocardial infarction. A randomized controlled trial]

Abstract

Introduction: The aim of the study was to examine the effect of group based psychosocial rehabilitation following discharge compared to usual care.

Material and methods: A randomised clinical trial was performed in the setting of a coronary unit at Herlev University Hospital. The study sample included 200 patients admitted to the unit with a diagnosis of acute myocardial infarction. All patients received usual care. Besides, the intervention group was offered two group based outpatient counselling sessions with focus on reduction of risk factors and psychosocial adjustment after myocardial infarction. Coping strategies, anxiety and depression, general health, physical function and number of readmissions were measured on the basis of the questionnaires HAD and mini-MAC. Participants completed questionnaires before discharge and again six weeks and four months after discharge.

Results: The intervention did not significantly affect coping strategies, general health or physical function. The readmission rate was significantly lower in the intervention group compared to the control group. The mortality rate in the intervention group was lower after four months, one year and four years.

Discussion: Possible explanations for the lack of effect in psychosocial parameters are the complex target group with no restrictions in gender and age and no intervention targeted the relatives. The lower mortality rate in the intervention group might be due to the intervention. However, it could also be due to variables not available in this study, such as the type of infarction and changes in lifestyle.