Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .
The effects of interpersonal counselling on health-related quality of life after myocardial infarction.
AIM To evaluate the effects of interpersonal counselling on health-related quality of life after myocardial infa rct ion . BACKGROUND Depression is a risk factor for poor health-related quality of life after myocardial infa rct ion . Interpersonal counselling seems to reduce depressive symptoms and distress after myocardial infa rct ion . METHODS Myocardial infa rct ion patients ( n=103 ) were r and omised into an intervention group ( n=51 ) with 1 - 6 ( mean 4·6 ) interpersonal counselling-sessions focusing on managing depressive symptoms and a control group ( n=52 ) . Health-related quality of life after myocardial infa rct ion was measured with EuroQol-5D ( EQ-5D ) in hospital , at six and 18 months after discharge . RESULTS No differences in the changes of health-related quality of life were found between the groups during follow-up . However , health-related quality of life improved significantly in the intervention group . In the group of patients under 60 years , the effect of interpersonal counselling was significant in the intervention group compared with the control group . CONCLUSIONS Interpersonal counselling does not seem to improve health-related quality of life better than st and ard care after myocardial infa rct ion in general , but it does seem to be beneficial with younger myocardial infa rct ion patients . RELEVANCE TO CLINICAL PRACTICE There is a need to study the effects of interpersonal counselling further with younger myocardial infa rct ion patients and to develop the intervention further , before using it systematic ally as part of nursing practice
Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .