OBJECTIVE: Poor mood adjustment to chronic medical illness is often accompanied by decrements in function. The purpose of this study was to evaluate the effectiveness of a telephone-based intervention for psychological distress and functional impairment in cardiac illness.
METHODS: We conducted a Randomized-controlled trial and recruited survivors of acute coronary syndromes using the Hospital and Anxiety Depression Scale (HADS) with scores indicative of mood disturbances at 1-month post-discharge. Recruited patients were randomized to experimental or control status. Intervention patients received six 30-minute telephone counseling sessions to identify and address illness-related fears and concerns. Control patients received usual care. Patients’ responses to the HADS and the Workplace
Social Adjustment Scale (WSAS) were collected at baseline, 2, 3, and 6 months using interactive voice recognition technology. At baseline, the PRIME-MD was used to establish diagnosis of depression. We used mixed effects regression to study changes in outcomes.
RESULTS: We enrolled 100 patients. Mean age was 60; 67% of the patients were male. Findings confirmed that the intervention group had a 27% improvement in depression symptoms (P=.05), 27% in anxiety (P=.02), and a 38% improvement in home limitations. (P=.04) compared
with controls. Symptom improvement tracked those for WSAS measures of home function (P=.04) but not workplace function.
CONCLUSIONS: The intervention had a moderate effect on patient’s emotional and functional outcomes that were observed during a critical period in patients’ lives. Patient convenience, ease of delivery, and the effectiveness of the intervention suggest that the counseling can help patients adjust to chronic illness.