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Psychosocial support interventions in medical settings can improve survival

PLOS

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IMAGE: Psychosocial support improves medical patient survival as much as medical rehabilitation programs. Note: lnOR = natural logarithm of odds ratio of patient survival. lnHR = natural logarithm of the hazard... view more 

Credit: Timothy B. Smith and Connor Workman

Psychosocial support interventions that promote the health behaviors of patients in medical settings improve survival, according to a study published May 18 in the open-access journal PLOS Medicine by Timothy B. Smith of Brigham Young University, Provo, Utah, United States and colleagues. On average, psychosocial interventions prolonged medical patient life to the same extent as cardiac rehabilitation or treatments for alcoholism or smoking.

Hospitals, clinics, and health organizations have provided psychosocial support interventions for patients to supplement medical care. But variability exists among psychosocial interventions, and prior reviews of interventions augmenting psychosocial support in medical settings have reported mixed outcomes. Smith and his collaborators conducted a meta-analysis to assess the effectiveness of psychosocial support interventions in improving patient survival, and to identify factors associated with greater effectiveness. The authors searched the literature for relevant randomized controlled trials (RCTs) that were published from 1980 to 2020, and focused their analysis on 106 RCTs including a total of 40,280 patients in inpatient and outpatient health care settings.

Among 87 RCTs reporting data for discrete time periods, there was a 20% increased likelihood of survival among patients receiving psychosocial support compared to control groups receiving standard medical care. Among those studies, psychosocial interventions explicitly promoting health behaviors improved the likelihood of survival, whereas interventions without that primary focus did not. Across 22 RCTs reporting survival time, psychosocial interventions were associated with a 29% increased probability of survival over time. Studies with patients having relatively greater disease severity tended to yield smaller gains in survival time relative to control groups. According to the authors, future psychosocial support interventions targeted at medical patients should address health behaviors such as motivation to adhere to treatments rather than focusing solely on emotional and psychological support.

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Research Article

In your coverage please use this URL to provide access to the freely available paper:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003595

Funding: The author(s) received no specific funding for this work.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Smith TB, Workman C, Andrews C, Barton B, Cook M, Layton R, et al. (2021) Effects of psychosocial support interventions on survival in inpatient and outpatient healthcare settings: A meta-analysis of 106 randomized controlled trials. PLoS Med 18(5): e1003595. https://doi.org/10.1371/journal.pmed.1003595

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