PSYCHOSOCIAL INTERVENTIONS IN CANCER AND HEART DISEASE

The effects of psychosocial interventions in cancer and heart disease: a review of systematic reviews

Background

This review looked at existing systematic reviews in order to (i) examine the types of psychosocial interventions that have been used with people suffering from heart disease or cancer, (ii) evaluate the effects of such interventions on physical outcomes, psychological outcomes or health care usage, and (iii) evaluate the methodological quality of the included systematic reviews.

Findings

Cancer : In general, the reviews of psychosocial interventions in cancer patients indicate that this type of intervention is likely to produce some beneficial effect on psychological distress or emotional adjustment of patients. The effects on specific outcomes such as depression are unclear. Findings relating to the relative effects of different treatment settings and paradigms (e.g. CBT vs. counselling) are inconsistent. The findings of reviews investigating physical outcomes (such as immune outcomes, survival) mostly failed to detect any beneficial effect of psychosocial intervention on these outcomes, though there is insufficient high quality evidence to determine whether small effects might exist.

Heart disease : Six of the eight heart disease reviews favour the adoption of psychosocial interventions into cardiac care. Those reviews that investigated psychological outcomes generally report some benefit of psychosocial interventions for the reduction of psychological distress and modification of type A behaviour (a behaviour pattern characterised by aggressiveness, ambitiousness, restlessness and a strong sense of time urgency). There is some limited evidence about the positive effects of psychosocial interventions on morbidity and mortality. There is equivocal evidence about the effects of psychosocial interventions on heart disease risk factors. Educational interventions may influence some behavioural (e.g. exercise and diet) and clinical (blood pressure and mortality) outcomes in heart disease.

Conducted by: Mark Rodgers1, Debra Fayter1, Gerry Richardson2, Gill Ritchie1, Robert Lewin3, Amanda J Sowden1

1. Centre for Reviews and Dissemination; 2. Centre for Health Economics, University of York; 3. Department of Health Sciences, University of York

Publications

Centre for Reviews and Dissemination. The effects of psychosocial interventions in cancer and heart disease: a review of systematic reviews. CRD Report 30. York: University of York. 2005

Posters

Rodgers M, Fayter D, Richardson G, Richie G, Sowden A, Lewin R. Reviewing the results of systematic reviews: the effects of psychosocial interventions in cancer and heart disease. Health Technology Assessment International (HTAi) Annual Meeting; May/June 2004; Krakow, Poland

Funding

Commissioned by One Health