Effects of mindfulness-based interventions on health-related outcomes for patients with heart failure: a systematic review

Background: Mindfulness-based interventions may offer a promising approach for promoting psychological and physical health and wellbeing for patients with heart failure. However, the effects of mindfulness-based interventions for this population have not been systematically reviewed. Aims: This review aimed to synthesise available evidence to assess the effects of mindfulness-based interventions on psychological and physical outcomes and health-related quality of life in patients with heart failure. Methods: Seven English and two Chinese electronic databases were searched with keywords from inception to May 2019. Experimental studies that examined mindfulness-based interventions in adults with heart failure were eligible for inclusion. Two reviewers independently performed study selection, data extraction and study quality assessment. The results were then narratively synthesised. Results: This review identified five studies involving 467 patients with heart failure. The reviewed studies had weak to moderate quality. There were consistent findings that mindfulness-based interventions could significantly reduce depression (three studies) and anxiety (two studies) and improve health-related quality of life (two studies) after intervention. However, the effects on physical symptoms were inconsistent in three studies. The effects on physical function were only measured in one study, with non-significant changes being reported. Conclusions: This review provides preliminary evidence that mindfulness-based interventions are beneficial for patients with heart failure in reducing depression and anxiety and enhancing health-related quality of life in the short term. These findings should be carefully generalised considering the methodological limitations across studies. More rigorous studies are required to examine further the effects of mindfulness-based interventions in patients with heart failure.