OTRNMeta-AnalysisNursing & health sciences2025

Dyadic Interventions for Promoting Healthy Diets in Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis.

Yongyang Yan, Yangxi Huang, Man Ping Wang and 3 others

PMID 40704437

WHAT IT FOUND

Diet interventions that included an adult patient's informal caregiver lowered sodium and improved short-term self-care, knowledge and support.

They did not improve lipids, and many benefits faded over longer follow-up.

Key findings

01Dyadic interventions reduced 24-hour urinary sodium by 566.05 mg at 1.5-4 month follow-up, equivalent to 1.42 g salt over 24 hours.

02Dyadic interventions improved self-care behavior at 1-3.5 month follow-up but not at 2-12 month follow-up.

03Dyadic interventions did not significantly improve triglyceride or total cholesterol levels.

STILL TO COME

How it was doneWhat they foundWhat it means for OTsWhat it means for RNs

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What it does not show

Only English-language studies were included, so cultural and language context may limit generalisability. Many interventions combined dietary change with physical activity or psychological education, so the effect of diet or caregiver involvement alone cannot be isolated. Dropout rates ranged from 0% to 46.2%, with a mean of 19.5%, and most studies did not state whether both members of the dyad dropped out. Several benefits were short-term and were not maintained at longer follow-up. Sensitivity analyses changed or removed significance for some sodium, fat, BMI and salty-food results, so effects are not fully robust. Caregiver outcomes were not pooled because few studies reported them. Intervention descriptions were often too brief to identify dyadic strategies or caregiver characteristics, so it is unclear what made programmes work.

Declared interests

The authors declared nothing to report. One author is a member of the journal's editorial board.

The easy way to misread this

Do not conclude that caregiver involvement alone caused the dietary benefits. Many studies combined diet with physical activity or psychological education, and several positive effects were only short-term or changed in sensitivity analyses.

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