JOURNAL OF ADVANCED NURSING

REVIEW SUMMARIES: EVIDENCE FOR NURSING PRACTICE
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Summaries of systematic reviews on nursing-related issues from the Cochrane Library, Joanna Briggs Institute and other evidence review organizations

Title Psychosocial interventions for smoking cessation in patients with coronary heart disease. Reference
Barth J., Critchley J. & Bengel J. (2008) Psychosocial interventions for smoking cessation in patients with coronary heart disease. Cochrane Database of Systematic Reviews, Issue 1, Art. No: CD006886. DOI: 10.1002/14651858. CD006886.pub2. Date of most recent substantive amendment: 3 October 2007. The full review report, including references, can be accessed using the digital object identifier, doi: 10.1002/14651858. CD006886.pub2.

diagnosis of coronary heart disease. Many interventions have been suggested to promote smoking cessation following coronary heart disease. The systematic review addressed psychosocial interventions for smoking cessation in patients with coronary artery disease.

Characteristics of the evidence
Sixteen randomized controlled trials (RCTs) were included in the review. It was impossible to retrieve information on randomization from many of the reports. A total of 2677 people were randomized into the included trials, with 1354 receiving a psychosocial intervention. All participants were smokers at baseline, with the majority being older males with coronary heart disease. Meta-analysis was performed where possible. • Behavioural therapeutic interventions had statistically significant effects on cessation of smoking. • Telephone support and self-help measures were statistically significant effective interventions for smoking cessation. • Brief psychosocial interventions (no follow-up or followup within 4 weeks of treatment) were ineffective. Followup periods of more than a month considerably increased the chance of smoking cessation. • The effect of psychosocial interventions for smoking cessation in the long-term (5 years) did not result in fewer smokers than in the control group. This finding must be interpreted with caution, however, as it was drawn from only two trials with high dropout rates. • Compared with usual care, psychosocial interventions had statistically significant effects on smoking cessation at 6–12 months.

Review question
What is the effectiveness of psychosocial interventions for smoking cessation in patients with coronary heart disease?

Type of review
Cochrane review with meta-analysis.

Relevance for nursing
Smoking is associated with many negative risk factors for health; one of these is coronary heart disease. A smoker is more likely than a non-smoker to suffer a myocardial infarction, and has an increased chance of developing cardiovascular disease. Following a cardiac event, smokers are more likely to suffer another event or to die. Quitting smoking following a cardiovascular event can lead to a reduction in mortality and myocardial infarction. Despite these facts, many smokers continue to smoke after a

Implications for nursing
• Psychosocial interventions that last longer than 1 month are effective for cessation of smoking in patients with coronary heart disease.
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Ó 2008 The Author. Journal compilation Ó 2008 Blackwell Publishing Ltd

Review Summaries Implications for research • There is a need for rigorously conducted large-scale RCTs to assess psychosocial interventions for smoking cessation after diagnosis of coronary heart disease.au 458 Ó 2008 The Author. South Australia e-mail: jbi@adelaide. Keywords: Cochrane review. 457–458. The role of nicotine replacement therapy needs to be evaluated in psychosocial interventions. Trials comparing different psychosocial interventions to each other are needed. Journal compilation Ó 2008 Blackwell Publishing Ltd . & Bengel J. smoking cessation MUNN Z. Critchley J. (2008) Psychosocial interventions for smoking cessation in patients with coronary heart disease. with interventions described with full details. (2008) Review Summaries: Barth J. This summary was prepared by Zachary Munn BMR (NM) Joanna Briggs Institute Adelaide..edu. heart disease. Journal of Advanced Nursing 64(5).