Home visit v telephone follow up in phase II cardiac rehabilitation following myocardial infarction: Effects on anxiety, depression, attendance at Phase III and visits to A&E or readmission

The effect of two interventions, telephone call and home visit, in Phase II cardiac rehabilitation were examined. Twenty-five patients were recruited during Phase I following myocardial infarction, twenty-one males and four females aged 33-87 (mean 67.2, SD13.9) years who were grouped as older (males >70, females >75) or younger. The study used a prospective independent groups design with random assignment to receiving a telephone call (usual treatment) or home visit in Phase II. Repeat measurements of anxiety and depression were conducted in Phase I and at the end of Phase III using the Hospital Anxiety and Depression Scale and attendance at Phase III, visits to A&E or readmission with cardiac symptoms were recorded. Results were analysed using SPSS (version 14) and median anxiety and depression scores for subgroups consisting of older and younger attenders and non-attenders of Phase III. After Phase III there were no significant differences in anxiety (p=0.615) or depression (p=0.085) scores although there was a trend towards lower scores for telephone call recipients. There was no significant difference between the intervention groups (p=0.513) or age groups (p=0.275) for attendance at Phase III although there was a trend towards younger and telephone call groups attending. There were no significant differences between attenders and non-attenders for anxiety after Phase III (p=0.937) but there was a marginal difference for depression (p=0.057) with lower scores for attenders. No patients were readmitted or attended A&E with cardiac symptoms during the study period. The study found that within subgroups attendance at Phase III appeared to be the factor that most affected anxiety and depression regardless of intervention or age group but the numbers in each subgroup were small and therefore these results had to be treated with caution.The College of Occupational Therapists and The Elizabeth Casson Trust for financial assistance towards university dissertation fees annd Sutton & Merton PCT for financial assitance towards module fees