The effect of a psychosocial intervention and quality of life after acute myocardial infarction: The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial

Carlos F. Mendes De Leon, Susan M. Czajkowski, Kenneth E. Freedland, Heejung Bang, Lynda H. Powell, Colin Wu, Matthew M. Burg, Vicki DiLillo, Gail Ironson, Harlan M. Krumholz, Pamela Mitchell, James A. Blumenthal

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

PURPOSE: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) clinical trial was designed to test whether intervening on depression or low perceived social support reduces mortality and reinfarction in patients with acute myocardial infarction (MI). This report analyzes the effect of the intervention on quality of life (QOL), which was an important secondary outcome. METHODS: ENRICHD was a randomized controlled clinical trial comparing a psychosocial intervention based on cognitive behavioral therapy to usual medical care in 2,481 patients from 8 clinical centers. Patients with acute MI were included if they met criteria for depression, low perceived social support, or both. QOL was assessed at the 6-month clinic visit in the first 1,296 patients. QOL measures included the Medical Outcomes Study Short Form summary measures of physical functioning (SF12-PCS) and mental functioning (SF12-MCS), a Life Satisfaction Scale (LSS), and a measure of overall QOL based on the ladder of life (LOL) technique. RESULTS: There were significant treatment differences on the SF12-MCS (difference 2.2, 95% confidence interval [CI] 1.2-3.2), the LSS (difference 1.0, 95% CI 0.5-1.5), and the LOL (difference 0.3, 95% CI 0.1-0.6), but not on the SF12-PCS (difference 0.8; 95% CI = -0.5-2.0). Effect sizes for the intervention on QOL outcomes were modest. CONCLUSIONS: Psychosocial interventions of limited duration confer modest QOL benefits in post-MI patients who are depressed or have low perceived social support. Interventions of longer duration or greater intensity may be required to produce more substantial improvements in QOL in these patients.

Original languageEnglish (US)
Pages (from-to)9-15
Number of pages7
JournalJournal of Cardiopulmonary Rehabilitation
Volume26
Issue number1
DOIs
StatePublished - Jan 1 2006
Externally publishedYes

Keywords

  • Acute myocardial infarction
  • Clinical trials
  • Psychosocial interventions
  • Quality of life

ASJC Scopus subject areas

  • Rehabilitation

Fingerprint Dive into the research topics of 'The effect of a psychosocial intervention and quality of life after acute myocardial infarction: The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial'. Together they form a unique fingerprint.

  • Cite this

    Mendes De Leon, C. F., Czajkowski, S. M., Freedland, K. E., Bang, H., Powell, L. H., Wu, C., Burg, M. M., DiLillo, V., Ironson, G., Krumholz, H. M., Mitchell, P., & Blumenthal, J. A. (2006). The effect of a psychosocial intervention and quality of life after acute myocardial infarction: The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial. Journal of Cardiopulmonary Rehabilitation, 26(1), 9-15. https://doi.org/10.1097/00008483-200601000-00002