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Nurse-led telephone-based follow-up interventions play a role in patient follow-up, but at present, no meta-analysis has been found to assess the effectiveness of nurse-led, telephone follow-up interventions for patients with acute coronary syndrome.
This systematic review and meta-analysis aimed to evaluate the effectiveness of nurse-led telephone-based follow-up interventions on health outcomes in people with acute coronary syndromes.
Systematic review and meta-analysis of randomized controlled trials.
A comprehensive search of six databases: PubMed, Web of Science, Embase, Cochrane Library, CINAHL and Scopus was conducted from the inception of the databases to 30 September 2023. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the included randomized controlled studies. Review Manager 5.4 and Stata 16.0 were used to conduct statistical analysis.
A total of 12 studies were included. Nurse-led telephone-based follow-up interventions may reduce systolic and diastolic blood pressure (MD = −2.55, 95% CI [−4.16, −0.94]) (MD = −2.15, 95% CI [−3.18, −1.12]) and low-density lipoprotein (MD = −9.06, 95% CI [−14.33, −3.79]) in patients with acute coronary syndrome. However, its effectiveness in controlling high-density lipoprotein (MD = 1.65, 95% CI [−4.30, 7.61]) and reducing total cholesterol (MD = −2.72, 95% CI [−7.57, 2.13]) was uncertain. In addition, the results showed that the nurse-led follow-up intervention did not play a role in improving anxiety (SMD = −0.20, 95% CI [−0.44, 0.04]) and depression (SMD = −0.07, 95% CI [−0.21, 0.06]) in patients with acute coronary syndrome, but it probably improved drug adherence (RR = 1.30, 95% CI [1.05, 1.60]) and smoking cessation (RR = 1.31, 95% CI [1.08, 1.60]).
The findings of this review suggest that nurse-led telephone-based follow-up interventions had a potentially positive effect on controlling blood pressure and low-density lipoprotein levels, as well as improving medication adherence and smoking cessation among patients with acute coronary syndrome, compared to usual care. However, the intervention did not appear to significantly impact high-density lipoprotein, total cholesterol, anxiety, and depression, indicating that further research in these areas will be necessary in the future.
PROSPERO (International Prospective Register of Systematic Reviews): CRD42023465894
Physiological, psychological, and social changes may make older adults more vulnerable to stressors and lead to adverse health outcomes. It remains unclear whether interventions targeting coping strategies in older adults are effective.
This study aimed to systematically review and summarize existing interventions aimed at improving coping strategies in older adults and analyze intervention effectiveness.
A systematic search was conducted using PubMed, EMBASE, Web of Science, Cochrane, CINAHL, PsycINFO, CNKI, SinoMed, VIP, and WanFang databases for randomized controlled trials (RCTs) and quasi-experimental studies. Two researchers independently performed literature screening, quality assessment, and data extraction.
A total of 9 studies were included, comprising 7 RCTs and 2 quasi-experimental studies. Meta-analysis revealed that the interventions significantly enhanced the use of problem-focused coping strategies among older adults (SMD = 0.37, 95% CI: 0.12 ~ 0.63, p = 0.005, I 2 = 39%). However, there was no significant effect on emotion-focused coping strategies (SMD = −0.07, 95% CI [−0.62, 0.48], p = 0.80, I 2 = 76%). Moreover, no significant statistical differences were observed between the intervention group and the control group in terms of positive (SMD = 1.49, 95% CI [−0.23, 3.21], p = 0.09, I 2 = 98%) or negative coping strategies (SMD = −0.76, 95% CI [−1.79, 0.28], p = 0.15, I 2 = 96%).
Interventions targeting coping strategies can significantly improve the problem-focused coping strategies of older adults. It is crucial to help older adults accurately recognize daily stressors, acquire emotional regulation strategies, and enhance coping skills. More large-scale RCTs are needed to draw more robust conclusions.
Cognitive decline, including subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia, significantly affects social participation, leading to social isolation and reduced quality of life. Enhancing social participation through interventions may mitigate these effects, yet evidence on intervention effectiveness and mechanisms remains inconsistent.
To evaluate the effectiveness of social participation interventions for individuals with cognitive decline and identify effective behavior change techniques (BCTs) supporting social participation.
Our search using the following databases—PubMed, Web of Science, Embase, Cochrane Library, CINAHL, Scopus, CNKI, and Wanfang—was conducted until October 2024. The quality of the included studies was assessed using the Cochrane risk of bias tool for randomized trials. Meta-analyses were conducted using Review Manager 5.4 and Stata18, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Sixteen RCTs involving 2190 participants were included. Music therapy (SMD = 0.62, 95% CI [0.15, 1.10]) and reminiscence therapy (SMD = 0.34, 95% CI [0.02, 0.66]) demonstrated significant positive effects on social participation. Group-based interventions were particularly effective (SMD = 0.23, 95% CI [0.04, 0.43]). Commonly used BCTs included goal setting, behavioral practice/rehearsal, and social support. However, substantial heterogeneity and limited data on SCD and MCI restricted generalizability.
Interventions promoting social participation may enhance engagement for individuals with cognitive decline, particularly through music therapy, reminiscence therapy, and group-based formats. The complexity and dynamic nature of social interaction require individuals to engage and integrate various cognitive functions and skills, which can present significant challenges for older adults with cognitive impairments in their daily social participation. Further research is needed to optimize intervention components and address gaps in targeting early cognitive decline stages.
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