The psychological effects of interventions targeting caregivers of patients with heart disease, a systematic review

Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): University College Copenhagen, Denmark.

Background
The healthcare system is facing major challenges due to an increasing number of patients with chronic diseases, including patients with cardiovascular diseases. As a consequence more caregivers will experience having a greater role in the treatment and care of their loved ones. This can have significant psychological consequences for the caregivers. For that reason, there is a need for evidence-based interventions that support caregivers of patients with cardiovascular disease.

The aim: Is to contribute with evidence-based knowledge about the effects of interventions supporting caregivers in the care and treatment of patients with heart disease focusing on psychological effects.

Method
A systematic review has been conducted based on the methodology described by Cochrane Handbook (2022). The following databases have been searched: Pubmed, Embase, Cochrane Library, CINAHL & PsychInfo. The literature search was carried out on the basis of the developed search strategy and studies were collected based on pre-specified inclusion and exclusion criteria. Subsequently, a critical quality assessment using RoB-2 quality assessment tool, a data extraction and a data synthesis were carried out after.

Results
The systematic search revealed 3,659 manuscripts, from where eight randomized controlled studies were included. The results of the data synthesis showed that the interventions were heterogeneous in regard to timing, intensity, and length of interventions. Most of the interventions included educational face-to-face sessions, in combination with telephone support or written resources. Likewise, the synthesis showed inconsistent results across studies, but positive effects were seen on caregivers (including caregiver burden, quality of life and depression) in some studies and no harm were observed in any study. The results indicated that the intensity of the interventions was related to better outcomes.

Conclusion
The included studies contribute knowledge about the psychological effects of interventions targeting caregivers of patients with cardiovascular diseases. Overall, inconsistencies were found across studies, which can be expected to be attributed to the heterogeneity across the complex interventions. There is a need for further research in the area to map which elements or combinations of elements that are ideal to test in future interventions. The development of effective interventions supporting caregivers and their well-being is of great importance, as it has the potential to benefit patients, caregivers, as well as society in general.