Telephone-delivered health coaching improves anxiety outcomes after myocardial infarction: the 'ProActive Heart' trial

Background: Cardiac rehabilitation has been shown to improve psychological outcomes after a cardiac event. However, uptake and adherence to structured rehabilitation programs is often poor. Novel and contemporary approaches to rehabilitation could improve important psychological outcomes of patients following myocardial infarction. The aim of the study was to investigate the effects of a telephone-delivered, health coaching program on depression and anxiety outcomes ofmyocardial infarction patients. Methods: Patients admitted to one of two tertiary hospitals in Brisbane, Australia following myocardial infarction were assessed for eligibility. 430 patients were recruited and randomly assigned to usual care (n = 215) or an intervention group (n = 215) comprising up to 10 telephone-delivered, `health coaching? sessions (ProActive Heart). Regression analysis compared Hospital Anxiety and Depression Scale scores of intervention and usual care groups at six-months. Results: During the six month intervention period, 83 of participants randomised to receive health coaching received at least 5 of 10 possible telephone sessions. The median number of sessionswas 8 and the mean call length was 26 min. The intervention yielded reductions in anxiety at follow-up (mean difference =-0.7, 95 CI =-1.4, -0.02), compared with usual care. A similar pattern was observed in mean depression scores but was not statistically significant. Conclusions: The ProActive Heart program effectively improves anxiety outcomes of patients following myocardial infarction. If combined with psychological-specific treatment, this program could impact anxiety of greater intensity in a clinically meaningful way.