Social cognitive intervention following an initial implantable cardioverter defibrillator: Better treatment response for secondary versus primary prevention

Published on May 4, 2020in Pacing and Clinical Electrophysiology1.976
路 DOI :10.1111/PACE.13929
Jonathan P. Auld2
Estimated H-index: 2
(UW: University of Washington),
Elaine A. Thompson26
Estimated H-index: 26
(UW: University of Washington),
Cynthia M. Dougherty20
Estimated H-index: 20
(UW: University of Washington)
Sources
Abstract
BACKGROUND: The Patient+Partner (P+P) is a patient/partner-focused social cognitive intervention with demonstrated efficacy to improve outcomes following an initial ICD. Little is known about how the patient response may differ by ICD implant indication. The aim of this study was to examine the response to intervention for patients with an initial ICD by reasons for primary vs. secondary ICD indication. METHOD: A longitudinal secondary analysis of data from a RCT testing the P+P intervention examined patient health outcomes over 12 months, stratified by the indication for the ICD: primary prevention without CRT (1(o) No CRT-n = 100), primary prevention with CRT (1(o) CRT-n = 78), secondary prevention after cardiac arrest (2 degrees Cardiac Arrest-n = 66), and secondary prevention for other arrhythmias (2(o) Other-n = 57). Outcomes included physical and mental health status (Short-Form-36 PCS and MCS), physical symptoms (Patient Concerns Assessment), depression (Patient-Health-Questionniare-9) and anxiety (State-Trait Anxiety Inventory). RESULTS: Participants (n = 301) were on average 64 years old, primarily male (73.7%) and Caucasian (91%) with reduced ejection fraction (34%). There were no baseline differences between ICD groups for all outcomes (p > 0.05). Patients in the 2 degrees Cardiac Arrest group showed greater improvement from baseline to 3 months in physical and mental health outcomes. The 2 degrees Cardiac Arrest group had better physical (F = 11.48, p = 0.004) and mental health (F = 4.34, p = 0.038) and less severe physical (z = 2.24, p = 0.013) and depressive symptoms (z = 2.71, p = 0.003) at 12 months compared to the 1(o) No CRT group. CONCLUSION: The P+P intervention was more effective for promoting physical and psychological health outcomes for individuals receiving an ICD for 2(o) prevention after cardiac arrest. This article is protected by copyright. All rights reserved.
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#1Cynthia M. Dougherty (UW: University of Washington)H-Index: 20
#2Elaine A. Thompson (UW: University of Washington)H-Index: 26
Last. Peter J. Kudenchuk (UW: University of Washington)H-Index: 61
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Background Interventions to improve physical and psychological outcomes in recipients with an initial implantable cardioverter-defibrillator (ICD) and their intimate partners are largely unstudied, though likely to have a major impact on adjustment to the ICD and general well-being. Objective The purpose of this study was to report the primary outcomes of the patient plus partner randomized controlled trial. Methods In a 2-group (N = 301) prospective randomized controlled trial, we compared 2 so...
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Glenn N. Levine, MD, FACC, FAHA, Chair Patrick T. O鈥橤ara, MD, MACC, FAHA, Chair-Elect Jonathan L. Halperin, MD, FACC, FAHA, Immediate聽Past Chair [露][1] Sana M. Al-Khatib, MD, MHS, FACC, FAHA Joshua A. Beckman, MD, MS, FAHA Kim K. Birtcher, MS, PharmD, AACC Biykem Bozkurt, MD, PhD, FACC,
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Last. Kumaraswamy Nanthakumar (U of T: University of Toronto)H-Index: 28
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Background We sought to examine the mortality impact of appropriate implantable cardioverter defibrillator (ICD) therapy between patients who received ICD for primary versus secondary prevention purposes. Methods and Results From a prospective, population鈥恇ased registry, we identified 7020 patients who underwent de novo ICD implantation between February 2007 and May 2012 in Ontario, Canada. The primary outcome was all鈥恈ause mortality. We used multivariable Cox proportional hazard modeling to adj...
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Background Long-term trends in use of implantable cardioverter-defibrillators (ICDs) and outcomes are rare. Objective We examined 13-year nationwide trends in ICD implantation and survival rates in Denmark. Methods Using medical databases, we identified all first time ICD recipients in Denmark during 2000鈥2012 (N = 8460) and ascertained all-cause mortality. We computed standardized annual implantation rates and mortality rate ratios according to age, sex, comorbidity level, indication, and devic...
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#1Jonathan P. Auld (UW: University of Washington)H-Index: 2
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This study examined differential responses among partners who participated in a RCT designed to compare two social cognitive theory interventions, one designed for patients only (P-only) and one for patients and their intimate partners (P鈥+鈥塒). The interventions were delivered following the patient receiving an initial ICD implant. Partner health outcomes were examined longitudinally from baseline at hospital discharge to 3, 6, and 12聽months. Outcomes included 6 measures: partner physical and me...
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#1Vivi Skibdal Frydensberg (University of Southern Denmark)H-Index: 2
#2Jens Brock Johansen (OUH: Odense University Hospital)H-Index: 3
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AIMS To investigate (i) the prevalence of anxiety and depression and (ii) the association between indication for implantable cardioverter-defibrillator (ICD) implantation and sex in relation to anxiety and depression up to 24 months' follow-up. METHODS AND RESULTS Patients with a first-time ICD, participating in the national, multi-centre, prospective DEFIB-WOMEN study (n鈥=鈥1496; 18% women) completed the Hospital Anxiety and Depression Scale at baseline, 3, 6, 12, and 24鈥塵onths. Data were analys...
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