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- Title
Effectiveness and Cost-Effectiveness of Self-Management Interventions for Adults Living with Heart Failure to Improve Patient-Important Outcomes: An Evidence Map of Randomized Controlled Trials.
- Authors
Santero, Marilina; Song, Yang; Beltran, Jessica; Medina-Aedo, Melixa; Canelo-Aybar, Carlos; Valli, Claudia; Rocha, Claudio; León-García, Montserrat; Salas-Gama, Karla; Kaloteraki, Chrysoula; Niño de Guzmán, Ena; Ballester, Marta; González-González, Ana Isabel; Poortvliet, Rune; van der Gaag, Marieke; Spoiala, Cristina; Gurung, Pema; Willemen, Fabienne; Cools, Iza; Bleeker, Julia
- Abstract
Self-management interventions (SMIs) may enhance heart failure (HF) outcomes and address challenges associated with disease management. This study aims to review randomized evidence and identify knowledge gaps in SMIs for adult HF patients. Within the COMPAR-EU project, from 2010 to 2018, we conducted searches in the databases MEDLINE, CINAHL, Embase, Cochrane, and PsycINFO. We performed a descriptive analysis using predefined categories and developed an evidence map of randomized controlled trials (RCTs). We found 282 RCTs examining SMIs for HF patients, comparing two to four interventions, primarily targeting individual patients (97%) globally (34 countries, only 31% from an European country). These interventions involved support techniques such as information sharing (95%) and self-monitoring (62%), often through a mix of in-person and remote sessions (43%). Commonly assessed outcomes included quality of life, hospital admissions, mortality, exercise capacity, and self-efficacy. Few studies have focused on lower socio-economic or minority groups. Nurses (68%) and physicians (30%) were the primary providers, and most studies were at low risk of bias in generating a random sequence for participant allocation; however, the reporting was noticeably unclear of methods used to conceal the allocation process. Our analysis has revealed prevalent support techniques and delivery methods while highlighting methodological challenges. These findings provide valuable insights for researchers, clinicians, and policymakers striving to optimize SMIs for individuals living with HF.
- Subjects
HEART failure treatment; CINAHL database; MEDICAL databases; PSYCHOLOGY information storage &; retrieval systems; MEDICAL information storage &; retrieval systems; SOCIAL support; SELF-management (Psychology); SYSTEMATIC reviews; MORTALITY; HEALTH outcome assessment; PATIENTS; TREATMENT effectiveness; HOSPITAL admission &; discharge; SELF-efficacy; PATIENT monitoring; COST effectiveness; QUALITY of life; DESCRIPTIVE statistics; RESEARCH funding; MEDLINE
- Publication
Healthcare (2227-9032), 2024, Vol 12, Issue 3, p302
- ISSN
2227-9032
- Publication type
Article
- DOI
10.3390/healthcare12030302