Background: Patients with implantable cardioverter defibrillators (ICD) experience anxiety, depression and reduced quality of life (QoL). Patient support groups are recommended in national guidelines for follow-up of patients with ICDs; however, although ICD recipients share experiences of patients with other long-term conditions, their risk of recurrent shocks is something unique to these patients and it remains to be seen whether support groups also have a beneficial impact on well-being in ICD patients.
Objectives: This systematic review evaluates whether ICD support groups have a beneficial effect on mental well-being.
Methods: Literature searches were carried out in MEDLINE, Embase, CINAHL, PsycINFO and Web of Science. Eligible studies investigated patient-led support groups for ICD patients aged 18 years or older, using any quantitative or qualitative design. The Mixed-Methods Assessment Tool was used to assess quality. Quantitative results were grouped by outcomes indicative of ‘better mental health’ including measures of anxiety and QoL, and a meta-analysis was conducted. Thematic synthesis was used to generate analytic themes from the qualitative data. The data were integrated and presented using the Pillar Integration Process.
Results: Ten studies were included in this review. All studies bar one were non-randomised or had a qualitative design and patients had self-selected to attend a support group. Five contributed to the quantitative data synthesis and seven to the qualitative synthesis. Meta-analysis of anxiety and QoL measures showed no significant impact of support groups on mental well-being (Figure 1). Qualitative data showed that patients perceived benefit from attendance through sharing experiences and acceptance of life with an ICD, which encourages them to resume normal life activities.
Conclusion: This first systematic review and meta-analysis showed that while there is currently no quantitative evidence that ICD support groups have a significant beneficial effect on mental well-being, qualitative data show that patient support groups are perceived as beneficial by attendees. This suggests that we need other quantitative measures to assess the benefits of support groups for mental well-being. Attendees value the opportunity to share their experiences, which helps them to accept their new life with an ICD. Further research is recommended into the optimal format of support groups, level of involvement of healthcare professionals, and whether primary and secondary prevention ICD patients have different supportive needs. ❑
