Efficacy of psychosocial and vocational interventions for improving return to work outcomes in people following an acute myocardial infarction: A systematic review

Ms Sonal Wallace1, Dr Lisa O’Brien2

1Alfred Health, Prahran, Australia, 2Monash University, Melbourne, Australia

Aim: To examine the effects of psychosocial and vocational interventions delivered in the first three months post AMI compared with other interventions are effective for improving work outcomes.

Method: A search was completed for English language publications up to March 2016 across four electronic databases and grey literature. Studies were independently screened by two reviewers and assessing for risk of bias. A narrative synthesis and meta-analysis of the included studies was undertaken.

Results: Eighteen studies of varying quality were analysed. Individually delivered psychosocial and vocational interventions may improve work rates at 3 months (RR= 1.17; p = 0.05) when compared to usual care but there was no difference at 6 or 12 months. People receiving group or individual psychological / vocational counselling returned to work 6.33 days sooner than those who received usual care (95% CI -7.18 to -5.49; p<0.001).

Significance of Findings to Allied Health: Although psychosocial and vocational interventions show promise in people within three months of AMI, evidence is still limited. This can impact treatment options and interventions selected by health professionals when working with people who have sustained a MI. There is a need for more detailed, high-quality studies with valid comparison groups and adequate follow-up.