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Secondary prevention of cardiovascular disease: CBT, in combination with standard care, is effective

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Question: Is CBT an effective approach to the secondary prevention of cardiovascular disease (CVD) events?

Patients: 362 adults (aged ≤75 years) who were consecutively discharged from hospital following a coronary heart disease event. Inclusion criteria: hospitalisation for acute myocardial infarction, percutaneous coronary angiography or coronary artery bypass graft; being healthy enough to be referred back to primary care within 1 year of admission; not having participated in similar programmes and being Swedish speaking, living in the hospital catchment area and willing to undergo study randomisation. The sample represents 71.0% of the eligible population – 76.5% were male and 51.1% had been admitted following a myocardial infarction.

Setting: Uppsala University Hospital, Sweden; patients recruited between May 1996 and August 2002 and followed up to 2008.

Intervention: Cognitive behavioural therapy (CBT) delivered as 20 two-hour sessions over 1 year by an expert nurse or clinical psychologist, in addition to homework assignments. The intervention focused on stress management, time urgency and hostility, with key components of education, …

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