Effects of self-help post-myocardial-infarction rehabilitation on psychological adjustment and use of health services

Lancet. 1992 Apr 25;339(8800):1036-40. doi: 10.1016/0140-6736(92)90547-g.


A home-based exercise programme has been found to be as useful as a hospital-based one in improving cardiovascular fitness after an acute myocardial infarction. To find out whether a comprehensive home-based programme would reduce psychological distress, 176 patients with an acute myocardial infarction were randomly allocated to a self-help rehabilitation programme based on a heart manual or to receive standard care plus a placebo package of information and informal counselling. Psychological adjustment, as assessed by the Hospital Anxiety and Depression Scale, was better in the rehabilitation group at 1 year. They also had significantly less contact with their general practitioners during the following year and significantly fewer were readmitted to hospital in the first 6 months. The improvement was greatest among patients who were clinically anxious or depressed at discharge from hospital. The cost-effectiveness of the home-based programme has yet to be compared with that of a hospital-based programme, but the findings of this study indicate that it might be worth offering such a package to all patients with acute myocardial infarction.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Anxiety
  • Depression
  • Exercise
  • Female
  • Health Services / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / psychology
  • Myocardial Infarction / rehabilitation*
  • Self Care / psychology*
  • United Kingdom