{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:25:26Z","timestamp":1793132726083,"version":"4.5.0"},"reference-count":46,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["03C202_2002"],"award-info":[{"award-number":["03C202_2002"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,5,20]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"\n Objectives<\/jats:title>\n The main objective of the study is to investigate the short-term efficacy of Acceptance and Commitment Therapy (ACT) on the simultaneous modification of biological indicators of risk and psychological well-being in patients with coronary heart disease attending cardiac rehabilitation (CR).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n This was a two-arm randomised controlled trial comparing a brief, manualised, ACT-based intervention with usual care (UC).<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The study was conducted in an outpatient CR unit in Italy. Data collection took place from January 2016 to July 2017.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Ninety-two patients were enrolled and randomised, following an unbalanced randomisation ratio of 2:1 to the ACT group (n=59) and the control group (n=33). Eighty-five patients completed the ACT (n=54) and the UC (n=31) interventions and were analysed.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n The control group received UC, a 6\u2009weeks multidisciplinary outpatient CR programme, encompassing exercise training, educational counselling and medical examinations. The experimental group, in addition to UC, participated in the Acceptance and Commitment Therapy on HEART disease (ACTonHEART) intervention encompassing three group sessions based on ACT.<\/jats:p>\n <\/jats:sec>\n \n Outcomes<\/jats:title>\n The primary outcomes were Low Density Lipoproteins (LDL)cholesterol, resting systolic blood pressure, body mass index (BMI) and psychological well-being measured by the Psychological General Well-Being Index (PGWBI). Outcome measures were assessed at baseline and at the end of CR.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Based on linear mixed models, no significant group \u00d7 time interaction was observed for either the primary outcomes (\u03b2, 95% CI: PGWBI =\u22121.13, \u20136.40 to \u20134.14; LDL cholesterol =\u22122.13, \u201311.02 to \u20136.76; systolic blood pressure =\u22120.50, \u201310.76 to \u20139.76; diastolic blood pressure =\u22122.73, \u201310.12 to \u20134.65; BMI =\u22120.16, \u20131.83 to \u20131.51, all p values >0.05) or the secondary outcomes (all p values >0.05). A significant time effect was found for the PGWBI total (beta=4.72; p=0.03).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Although analyses revealed null findings, the results can inform the design of future ACT-based CR interventions and can help researchers to strike a balance between the idealised implementation of an ACT intervention and the structural limitations of existing CR programmes.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT01909102<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-084070","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T15:31:56Z","timestamp":1718206316000},"page":"e084070","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Effects of a brief intervention based on Acceptance and Commitment Therapy versus usual care for cardiac rehabilitation patients with coronary heart disease (ACTonHEART): a randomised controlled trial"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct01909102","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4807-9566","authenticated-orcid":false,"given":"Chiara A M","family":"Spatola","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Rapelli","sequence":"additional","affiliation":[{"name":"Department of Psychology Renzo Canestrari, Alma Mater Studiorum University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele Maria","family":"Giusti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Cattivelli","sequence":"additional","affiliation":[{"name":"Department of Psychology Renzo Canestrari, Alma Mater Studiorum University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina L","family":"Goodwin","sequence":"additional","affiliation":[{"name":"Cooper University Health Care, Camden, New Jersey, USA"},{"name":"Cooper University Medical School of Rowan University, Camden, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Pietrabissa","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano, Clinical Psychology Research Laboratory, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Malfatto","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS, Dipartimento di Scienze Cardiovascolari, Neurologiche, Metaboliche, Ospedale San Luca, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Facchini","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS, Dipartimento di Scienze Cardiovascolari, Neurologiche, Metaboliche, Ospedale San Luca, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele A M","family":"Cappella","sequence":"additional","affiliation":[{"name":"Catholic University of the Sacred Heart, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Varallo","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Martino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Castelnuovo","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano, Clinical Psychology Research Laboratory, Milan, Italy"},{"name":"Catholic University of the Sacred Heart, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"2025121403314860000_14.6.e084070.1","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2223-3652.2012.01.02"},{"key":"2025121403314860000_14.6.e084070.2","unstructured":"Tessler J , Bordoni B . 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