Using social support interventions to help people with heart disease

Using social support interventions to help people with heart disease

Vanessa Jordan
PEARLS No.
728
Clinical question

How effective are social network and social support interventions in supporting cardiac rehabilitation and secondary prevention for people with heart disease?

Bottom line

Despite the relatively large volume of included studies, this analysis indicates that the impact of social network or social support interventions for people with heart disease, as compared with usual care without social support (ie, secondary prevention alone or with cardiac rehabilitation), remains uncertain.

The review found weak evidence to suggest that social network or social support interventions may improve health-related quality of life and reduce systolic and diastolic blood pressure. There may be a reduction in all-cause and cardiovascular-related mortality at >12 months follow-up, but the certainty of evidence was low.

There was a lack of evidence relating to mortality (all-cause or cardiovascular-related at ≤12 months), morbidity (hospital admissions, rates of myocardial infarction or revascularisation) and adverse events.

Caveat

A notable limitation to the review emerged from the inconsistency in reporting of interventions trialled. The interventions reviewed were extremely diverse, and their component parts were not always clearly described; nor were measures of fidelity to intervention design always included.

Context

Globally, cardiovascular diseases (ie, coronary heart and circulatory diseases combined) contribute to 31% of all deaths – more than any other cause. There is some evidence to suggest that low levels of social support and social isolation are linked to poor health for people with heart disease.

In line with guidance in the UK and globally, cardiac rehabilitation programmes are widely offered to people with heart disease and include psychosocial, educational, health behaviour change, and risk management components. Social support and social network interventions have potential to improve the outcomes of these programmes, but whether and how these interventions work is poorly understood.

Cochrane Systematic Review

Purcell C, et al. Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. Cochrane Database Syst Rev 2023;6:CD013820. This review contains 54 trials with a total of 11,445 participants.