A systematic review of patient education in cardiac patients: do they increase knowledge and promote health behavior change?

Abstract

Objective: (1) To investigate the impact of education on patients' knowledge; (2) to determine if educational interventions are related to health behavior change in cardiac patients; and (3) to describe the nature of educational interventions.

Methods: A literature search of several electronic databases was conducted for published articles from database inception to August 2012. Eligible articles included cardiac patients, and described delivery of educational interventions by a healthcare provider. Outcomes were knowledge, smoking, physical activity, dietary habits, response to symptoms, medication adherence, and psychosocial well-being. Articles were reviewed by 2 authors independently.

Results: Overall, 42 articles were included, of which 23 (55%) were randomized controlled trials, and 16 (38%) were considered "good" quality. Eleven studies (26%) assessed knowledge, and 10 showed a significant increase with education. With regard to outcomes, educational interventions were significantly and positively related to physical activity, dietary habits, and smoking cessation. The nature of interventions was poorly described and most frequently delivered post-discharge, by a nurse, and in groups.

Conclusions: Findings support the benefits of educational interventions in CHD, though increase in patients' knowledge and behavior change.

Practice implications: Future reporting of education interventions should be more explicitly characterized, in order to be reproducible and assessed.

Keywords: Coronary disease; Health behavior; Patient education as topic; Systematic review.