Efficacy of cognitive behavioral therapy for heart failure: A meta-analysis of randomized controlled studies

Abstract

Cognitive behavioral therapy has emerged as an important approach to alleviate the depression of patients with heart failure. However, the use of cognitive behavioral therapy for heart failure has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of cognitive behavioral therapy for alleviating depression for heart failure. PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of cognitive behavioral therapy on heart failure are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. Meta-analysis is performed using the random-effect model. Eight RCTs involving 480 patients are included in the meta-analysis. Compared with control intervention for heart failure, cognitive behavioral therapy can substantially decrease depression scale (Std. MD = −0.27; 95% CI = −0.47 to −0.06; P = 0.01), but has no substantial influence on the quality of life (Std. MD = 0.21; 95% CI = −0.01 to 0.42; P = 0.06), self-care scores (Std. MD = 0.12; 95% CI = −0.18 to 0.42; P = 0.44), and 6-minute walk test distance (Std. MD = 0; 95% CI = −0.28 to 0.28; P = 0.99). Cognitive behavioral therapy is associated with significantly decreased depression scale, but with no substantial impact on the quality of life, self-care scores, and 6-minute walk test distance for heart failure.