The psychological effects of interventions targeting informal caregivers of patients with cardiovascular disease-a systematic review.

Clinical Snapshot

Key Findings

• P Value: Not reported at the review level

• Effect Size: No pooled effect size reported; 8 of 15 included RCTs reported statistically significant improvements in at least one caregiver psychological outcome

• Primary Outcome: Psychological outcomes of informal caregivers of CVD patients (including caregiver burden, anxiety, depression, quality of life, and psychological distress) following caregiver-targeted interventions

• Nnt Or Sensitivity: Not calculable from available data; no pooled estimate provided. Exploratory finding: interventions with more frequent caregiver and patient contact were more likely to demonstrate significant improvements in caregiver outcomes

• Confidence Interval: Not reported at the review level; individual study confidence intervals not synthesised

Clinical Application

Multicomponent interventions combining educational face-to-face sessions, telephone support, and written resources are broadly feasible within existing cardiac rehabilitation and chronic disease management frameworks. The finding that higher contact frequency may be associated with better outcomes has resource implications for healthcare systems. Implementation would require dedicated caregiver support roles within cardiac care teams. In Australia, informal caregivers of CVD patients are a substantial and often under-supported population. Cardiovascular disease remains the leading cause of death in Australia (Australian Institute of Health and Welfare). Cardiac rehabilitation programmes funded through the MBS (Medicare Benefits Schedule) primarily target patients rather than caregivers, representing a gap in current service delivery. The RACGP and Cardiac Society of Australia and New Zealand (CSANZ) have not yet issued specific guidelines for caregiver psychological support interventions. No PBS-listed pharmacological intervention is implicated. TGA considerations are not relevant to this non-pharmacological review. The findings support advocacy for caregiver inclusion in cardiac rehabilitation programme design, consistent with the National Carer Strategy and Carer Recognition Act 2010 (Cth). Australian cardiac nurses and allied health professionals in hospital and community settings are well-positioned to deliver such interventions if evidence of effectiveness is established. Adult informal caregivers (family members, partners, or close friends) of adult patients with cardiovascular disease, including but not limited to coronary artery disease, heart failure, and arrhythmia. Most applicable to caregivers engaged in active daily care and treatment support roles.

Abstract

AIMS: To explore the psychological effects of interventions aimed at supporting informal caregivers involved in the care and treatment of patients with cardiovascular disease. METHODS AND RESULTS: Databases (PubMed, CINAHL, Embase, Cochrane Library, and PsycInfo) were searched for studies in accordance with the Cochrane Handbook guidelines. Inclusion criteria were: caregivers of patients with one or more cardiovascular diseases, patient and caregiver >18 years, caregivers included in the intervention, and, reporting of psychological outcomes specific to caregivers. Study designs were randomized controlled trials with a follow-up periods of >2 months. The RoB 2.0 bias assessment tool was used to assess risk of bias. Fifteen studies from nine countries were identified. Most interventions consisted of multiple components including educational face-to-face sessions, telephone support, and/or written resources. The analysis showed inconsistent results on caregiver outcomes, but significant improvements were reported in eight studies in at least one caregiver outcome. Analysis indicated that the studies providing more frequent contact with caregivers and patients were more likely to report significant improvements in caregiver outcomes. Risk of bias was judged as low in three studies, some concerns in nine studies, and as high in three studies. CONCLUSION: Due to inconsistency in results, this review yield uncertainty about whether interventions targeting caregivers of patients with cardiovascular disease improve caregivers' psychological outcomes. Therefore, further research is needed to develop effective interventions for caregivers, as they play a vital role in the daily care and treatment of patients with cardiovascular disease. REGISTRATION: PROSPERO: CRD420250654618.

References

1. 1.Risom, S. S., Møller, E., Wind, G., Prip, A., Pii, K., Hillersdal, L., Christoffersen, N., Borregaard, B., Rasmussen, T. B., Christensen, E. H., & Grew, J. C. (2026). The psychological effects of interventions targeting informal caregivers of patients with cardiovascular disease-a systematic review. European Journal of Cardiovascular Nursing. Advance online publication. https://doi.org/10.1093/eurjcn/zvag049