The Effect of Cardiac Rehabilitation on Health Related Quality of Life in Patients with Coronary Artery Disease: A Meta-Analysis
Canadian Journal of Cardiology(2019)
摘要
ABSTRACT Background The clinical effectiveness of cardiac rehabilitation (CR) on health-related quality of life (HRQOL) is an area which has not been consistently explored. The objective of this systematic review was to evaluate the effectiveness of providing any core component of CR on HRQOL domains. Methods We performed a meta-analysis and meta-regression of randomized controlled trials (RCT) examining the core components of CR. RCTs included adult patients with diagnosed coronary artery disease via angiography, myocardial infarction, angina or who had undergone coronary revascularization. The Cochrane Library, MEDLINE, EMBASE, CINAHL, SCI-EXPANDED, Psych INFO and Web of Science were searched from inception to April 27 th , 2017. Outcomes included overall, physical, emotional and social HRQOL. Outcomes were reported as standardized mean change (SMC) with 95% confidence intervals. Effect size changes of 0.2, 0.5 and 0.8 SD units reflect a small, moderate and large effect respectively Results Forty-nine reports of 41 RCTs with 11,747 patients were included. Summary effect sizes were: overall HRQOL SMC 0.28 (95% CI 0.05 to 0.50), physical HRQOL SMC 0.47 (95% CI 0.13 to 0.81), emotional HRQOL SMC 0.37 (95% CI -0.02 to 0.77) and social HRQOL SMC 0.13 (95% CI -0.06 to 0.32). Meta-regression revealed type of CR intervention and year of publication as positive statistically significant treatment effect modifiers. Conclusion Receiving CR was shown to improve HRQOL, with exercise, non-exercise, and psychological based interventions playing a vital role. While these improvements in HRQOL were modest they still reflect an incremental benefit in comparison to receiving usual care.
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