Self-help groups for patients with coronary heart disease as a resource for rehabilitation and secondary prevention-what is the evidence?

Cardiovascular heart disease (CHD) is a major health care concern worldwide. Maintaining regular cardiac rehabilitation attendance and secondary-prevention strategies are significant health care challenges. Although self-help groups provide benefit for many chronic health conditions, it is not clear if they address the challenges of CHD rehabilitation and self-management. This literature review was guided by the following question: Can self-help groups address the challenges of CHD rehabilitation and self-management? This article reviews the traditional published and "grey" literature on CHD-related self-help groups identified from a database search (Cochrane Library, PubMed, PsychINFO, Medline, Cumulative index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, and Social Sciences Citation Index). Identified articles were screened based on the type of initiative: Community-based non-health service-organized groups were included, but hospital based group treatment and therapy interventions or programs were excluded. Published research and analysis of CHD-related self-help groups is scarce. Sixteen articles focusing on self-help groups were identified. The review results indicate that the limited quantity, limited range, and variable quality of studies prevents reliable conclusions being made regarding effects and outcomes as well as the extent and profile of participation. Strengthening the evidence base regarding the impact of CHD-related self-help groups, the reasons for participation versus nonparticipation in such groups, and determining nonparticipants support needs must be done to establish if and for which patients such groups constitute an effective resource for rehabilitation and secondary prevention. (Heart Lung (R) 2009;38:192-200.)