Abstract 12117: Self-Management Training Improves Chronic Angina Symptoms but not Psychological Burden

Abstract

PURPOSE: Cardiac pain arising from chronic stable angina (CSA) has a major negative impact on health-related quality of life (HRQL) including pain, poor general health status, psychological distress, and inability to self-manage.

METHODS: We used meta-analysis to assess the effectiveness of self-management training interventions for improving stable angina symptoms, health-related quality of life (HRQL) and psychological well-being. Nine trials, involving 1,282 participants in total, were included. We used standard inverse-variance random-effects meta-analysis to combine the trials. Heterogeneity between trials was evaluated using chi-square tests for the tau-squared statistic and was quantified using the I² statistic.

RESULTS: There was a significant improvement in the frequency of angina symptoms across trials, standardized mean difference (SMD) = 0.31 (95% Confidence interval [CI], 0.15 to 0.47). Self-management training also resulted in significant reduction in the use of sublingual (SL) nitrates, SMD= -0.45 (95% CI (-0.67, -0.22). A significant HRQL improvement (Seattle Angina Questionnaire) for physical limitation was also found, SMD= 0.38 (95% CI, 0.20 to 0.55). Self-management training did not improve other HRQL dimensions including disease perception and treatment satisfaction. There was no significant statistical heterogeneity across trials, I² range= 0% to 17%.

CONCLUSION: Self-management training interventions significantly reduce the frequency of angina symptoms and related use of SL nitrates. The inability of these interventions to impact other dimensions of HRQL may be due to the magnitude of the psychological burden imposed by chronic angina.