BACKGROUND: Chronic stable angina (CSA) has a major negative impact on health-related quality of life (HRQL) including poor general health status, psychological distress, and inability to self-manage. METHODS: We used meta-analysis to assess the effectiveness of self-management interventions for improving stable angina symptoms, HRQL and psychological well-being. Nine trials, involving 1,282 participants in total, were included. We used standard inverse-variance random-effects meta-analysis to combine the trials. Heterogeneity between trials was evaluated using Chi-square tests for the tau-squared statistic and quantified using the I2 statistic. RESULTS: There was significant improvement in the frequency of angina symptoms (Seattle Angina Questionnaire (SAQ), symptom diary) across trials, standardized mean difference (SMD) 0.30 (95% confidence interval (CI) 0.14 to 0.47), as well as reduction in the use of sublingual (SL) nitrates, SMD -0.49 (95% CI -0.77 to -0.20). Significant improvements for physical limitation (SAQ), SMD 0.38 (95% CI 0.20 to 0.55) and depression scores (Hospital Anxiety and Depression Scale), SMD -1.38 (95% CI -2.46 to -0.30) were also found. The impact of SM on anxiety was uncertain due to statistical heterogeneity across trials for this outcome, I2 = 98%. SM did not improve other HRQL dimensions including angina stability, disease perception, and treatment satisfaction. CONCLUSIONS: SM interventions significantly improve angina frequency and physical limitation; they also decrease the use of SL nitrates and improve depression in some cases. Further work is needed to make definitive conclusions about the impact of SM on cardiac-specific anxiety.

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