Other characteristics , including specialist versus generalist provision , did not appreciably impact programme effectiveness .
Conclusions Shorter secondary prevention programmes , those based in general practice , and those staffed by generalists are at least as effective in reducing all cause mortality in patients with coronary heart disease as longer programmes , hospital-based programmes , and programmes staffed by specialists
Background The aim of this study was to determine which programme characteristics influence the effectiveness of secondary prevention programmes for Coronary Heart Disease .
Psychological rehabilitation after myocardial infarction: multicentre randomised controlled trial
Abstract Objective : To evaluate rehabilitation  after myocardial infa rct ion . Design : R and omised controlled trial of rehabilitation in unselected myocardial infa rct ion patients in six centres , baseline data being collected on admission and by structured interview ( of patients and spouses ) shortly after discharge and outcome being assessed by structured interview at six months and clinical examination at 12 months . Setting : Six district general hospitals . Subjects : All 2328 eligible patients admitted over two years with confirmed myocardial infa rct ion and discharged home within 28 days . Interventions : Rehabilitation programmes comprising psychological therapy , counselling , relaxation training , and stress management training over seven weekly group outpatient sessions for patients and spouses . Main outcome measures : Anxiety , depression , quality of life , morbidity , use of medication , and mortality . Results : At six months there were no significant differences between rehabilitation patients and controls in reported anxiety ( prevalence 33 % ) or depression ( 19 % ) . Rehabilitation patients reported a lower frequency of angina ( median three versus four episodes a week ) , medication , and physical activity . At 12 months there were no differences in clinical complications , clinical sequelae , or mortality . Conclusions : Rehabilitation programmes based on psychological therapy , counselling , relaxation training , and stress management seem to offer little objective benefit to patients who have experienced myocardial infa rct ion compared with previous reports of smaller trials . Key messages In this series there were no important differences by age , sex , hospital , or baseline anxiety or depression At six months the prevalence rates of clinical anxiety and depression remained high ( 33 % and 19 % respectively ) Patients and spouses rated programmes highly , which suggests a “ quality of care ” role for
Other characteristics , including specialist versus generalist provision , did not appreciably impact programme effectiveness .
Conclusions Shorter secondary prevention programmes , those based in general practice , and those staffed by generalists are at least as effective in reducing all cause mortality in patients with coronary heart disease as longer programmes , hospital-based programmes , and programmes staffed by specialists
Background The aim of this study was to determine which programme characteristics influence the effectiveness of secondary prevention programmes for Coronary Heart Disease .