Objective: Cognitive behavioural therapy (CBT) is a set of techniques designed to help people to change health behaviours and improve their emotional wellbeing. We developed and delivered an 8-week group secondary prevention program - ‘Beating Heart Problems’ - for cardiac patients based upon CBT principles, designed as an adjunct to traditional CR.
Methods: A consecutive sample of 275 patients admitted to Royal Melbourne Hospital (RMH) and Melbourne Private Hospital (MPH) after acute myocardial infarction (32%) or for coronary artery bypass graft surgery (40%) or percutaneous coronary intervention (28%) was recruited into a randomised controlled trial. Comprehensive assessments were conducted at baseline and 4 and 12 months with data available on 213 participants (treatment = 119, control = 113).
Results: At four months, patients allocated to the CBT group program showed a significantly greater increase in functional capacity as assessed by the 6-minute walk test (baseline M(SD) = 511 (80)m; 4 month M(SD) = 547(74)m) than the control group (baseline M(SD) = 517 (90)m; 4 month M(SD) = 539(93)m), F(1,183)=4.33, p=.039). The CBT group also improved their self-reported dietary fat intake(baseline M(SD)=16.3(7.0); 4 month M(SD)=15.2(6.6)) while the control group scores worsened (baseline M(SD)=16.8 (8.2); 4 month M(SD)=17.5(6.9)), F(1,183)=4.33, p=.039. Two-year risk of a recurrent cardiac event was also examined, with trends favouring the treatment group.
Conclusions: There is potential for incorporating this CBT program into the existing cardiac rehabilitation service delivery model. Other options for delivery of the ‘Beating Heart Problems’ program will be discussed.