What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure?: An Individual Patient Data Meta-analysisDepartment of Cardiology, Hospital Reina Sofia, Cordoba, Spain .
British Heart Foundation, Glasgow, United Kingdom.
Department of Cardiology, Deventer Hospital, Deventer, Netherlands.
Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States.
Department of Health Services, University of Washington, Seattle, Washington, United States.
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States.
Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands.
Institute of Nursing Science, University of Basel, Basel, Switzerland.
Department of Cardiology, Deventer Hospital, Deventer, Netherlands.
Instituto Universitario de Ciencias de la Salud, Universidad de A Coruña and INIBIC, A Coruña, Spain .
Graduate School of Health Sciences, Hirosaki University, Aomori, Japan.
Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany .
Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, United States.
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden .
Division of Cardiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada .
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.
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2016 (Engelska)Ingår i: Journal of Cardiac Failure, ISSN 1071-9164, E-ISSN 1532-8414, Vol. 22, nr 11, s. 861-871Artikel i tidskrift (Refereegranskat) 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.
Ort, förlag, år, upplaga, sidor
2016. Vol. 22, nr 11, s. 861-871
Nyckelord [en]
Heart failure, individual patient data meta-analysis, self-management
Nationell ämneskategori
Kardiologi Omvårdnad
Identifikatorer
URN: urn:nbn:se:hj:diva-34066DOI: 10.1016/j.cardfail.2016.06.422ISI: 000388059200004PubMedID: 27374838Scopus ID: 2-s2.0-84994164408Lokalt ID: HHJADULTISOAI: oai:DiVA.org:hj-34066DiVA, id: diva2:1048617
2016-11-212016-11-212019-03-07Bibliografiskt granskad