Title |
What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis
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Published in |
Journal of Cardiac Failure, June 2016
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DOI | 10.1016/j.cardfail.2016.06.422 |
Pubmed ID | |
Authors |
Nini H. Jonkman, Heleen Westland, Rolf H.H. Groenwold, Susanna Ågren, Manuel Anguita, Lynda Blue, Pieta W.F. Bruggink-André de la Porte, Darren A. DeWalt, Paul L. Hebert, Michele Heisler, Tiny Jaarsma, Gertrudis I.J.M. Kempen, Marcia E. Leventhal, Dirk J.A. Lok, Jan Mårtensson, Javier Muñiz, Haruka Otsu, Frank Peters-Klimm, Michael W. Rich, Barbara Riegel, Anna Strömberg, Ross T. Tsuyuki, Jaap C.A. Trappenburg, Marieke J. Schuurmans, Arno W. Hoes |
Abstract |
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. 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%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. 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. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Netherlands | 2 | 67% |
Unknown | 1 | 33% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 67% |
Scientists | 1 | 33% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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United States | 1 | <1% |
Switzerland | 1 | <1% |
Unknown | 210 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 28 | 13% |
Researcher | 25 | 12% |
Student > Bachelor | 18 | 8% |
Student > Postgraduate | 16 | 8% |
Other | 14 | 7% |
Other | 50 | 24% |
Unknown | 61 | 29% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 54 | 25% |
Medicine and Dentistry | 50 | 24% |
Psychology | 6 | 3% |
Agricultural and Biological Sciences | 4 | 2% |
Unspecified | 4 | 2% |
Other | 24 | 11% |
Unknown | 70 | 33% |