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  • 1.
    Jonkman, Nini H.
    et al.
    Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, Netherlands.
    Westland, Heleen
    Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, Netherlands.
    Groenwold, Rolf H. H.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
    Ågren, Susanna
    Department of Medical and Health Sciences and Department of Cardiothoracic Surgery, Linköping University, Linköping, Sweden.
    Anguita, Manuel
    Department of Cardiology, Hospital Reina Sofia, Cordoba, Spain .
    Blue, Lynda
    British Heart Foundation, Glasgow, United Kingdom.
    Bruggink-André de la Porte, Pieta W. F.
    Department of Cardiology, Deventer Hospital, Deventer, Netherlands.
    DeWalt, Darren A.
    Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States.
    Hebert, Paul L.
    Department of Health Services, University of Washington, Seattle, Washington, United States.
    Heisler, Michele
    Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States.
    Jaarsma, Tiny
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    Kempen, Gertrudis I. J. M.
    Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands.
    Leventhal, Marcia E.
    Institute of Nursing Science, University of Basel, Basel, Switzerland.
    Lok, Dirk J. A.
    Department of Cardiology, Deventer Hospital, Deventer, Netherlands.
    Mårtensson, Jan
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Muñiz, Javier
    Instituto Universitario de Ciencias de la Salud, Universidad de A Coruña and INIBIC, A Coruña, Spain .
    Otsu, Haruka
    Graduate School of Health Sciences, Hirosaki University, Aomori, Japan.
    Peters-Klimm, Frank
    Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany .
    Rich, Michael W.
    Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, United States.
    Riegel, Barbara
    School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States.
    Strömberg, Anna
    Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden .
    Tsuyuki, Ross T.
    Division of Cardiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada .
    Trappenburg, Jaap C. A.
    Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, Netherlands.
    Schuurmans, Marieke J.
    Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, Netherlands.
    Hoes, Arno W.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
    What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure?: An Individual Patient Data Meta-analysis2016Ingår i: Journal of Cardiac Failure, ISSN 1071-9164, E-ISSN 1532-8414, Vol. 22, nr 11, s. 861-871Artikel i tidskrift (Refereegranskat)
    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.

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