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What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure?: An Individual Patient Data Meta-analysis
Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, Netherlands.
Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
Department of Medical and Health Sciences and Department of Cardiothoracic Surgery, Linköping University, Linköping, Sweden.
Vise andre og tillknytning
2016 (engelsk)Inngår i: Journal of Cardiac Failure, ISSN 1071-9164, E-ISSN 1532-8414, Vol. 22, nr 11, s. 861-871Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background

To identify those characteristics of self-management interventions in patients with heart failure (HF) that are effective in influencing health-related quality of life, mortality, and hospitalizations.

Methods and Results

Randomized trials on self-management interventions conducted between January 1985 and June 2013 were identified and individual patient data were requested for meta-analysis. Generalized mixed effects models and Cox proportional hazard models including frailty terms were used to assess the relation between characteristics of interventions and health-related outcomes. Twenty randomized trials (5624 patients) were included. Longer intervention duration reduced mortality risk (hazard ratio 0.99, 95% confidence interval [CI] 0.97–0.999 per month increase in duration), risk of HF-related hospitalization (hazard ratio 0.98, 95% CI 0.96–0.99), and HF-related hospitalization at 6 months (risk ratio 0.96, 95% CI 0.92–0.995). Although results were not consistent across outcomes, interventions comprising standardized training of interventionists, peer contact, log keeping, or goal-setting skills appeared less effective than interventions without these characteristics.

Conclusion

No specific program characteristics were consistently associated with better effects of self-management interventions, but longer duration seemed to improve the effect of self-management interventions on several outcomes. Future research using factorial trial designs and process evaluations is needed to understand the working mechanism of specific program characteristics of self-management interventions in HF patients.

sted, utgiver, år, opplag, sider
2016. Vol. 22, nr 11, s. 861-871
Emneord [en]
Heart failure, individual patient data meta-analysis, self-management
HSV kategori
Identifikatorer
URN: urn:nbn:se:hj:diva-34066DOI: 10.1016/j.cardfail.2016.06.422ISI: 000388059200004PubMedID: 27374838Scopus ID: 2-s2.0-84994164408Lokal ID: HHJADULTISOAI: oai:DiVA.org:hj-34066DiVA, id: diva2:1048617
Tilgjengelig fra: 2016-11-21 Laget: 2016-11-21 Sist oppdatert: 2019-03-07bibliografisk kontrollert

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