Effectiveness of self-management interventions on mortality, hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure: a systematic review

Patient Educ Couns. 2010 Mar;78(3):297-315. doi: 10.1016/j.pec.2010.01.016. Epub 2010 Mar 3.

Abstract

Objective: This review examined the effectiveness of self-management interventions compared to usual care on mortality, all-cause hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure.

Methods: A systematic review was performed. MEDLINE, EMBASE, CINAHL and the Cochrane Library were searched between 1996 and 2009. Randomized controlled trials were selected evaluating self-management interventions designed for patients with chronic heart failure. Outcomes of interest are mortality, all-cause hospital readmissions, chronic heart failure hospitalization rate and quality of life.

Results: Nineteen randomized controlled trials were identified. The effectiveness of heart failure management programs initiating self-management interventions in patients with chronic heart failure indicate a positive effect, although not always significant, on reduction of numbers of all-cause hospital readmitted patients and due to chronic heart failure, decrease in mortality and increasing quality of life.

Conclusion: This systematic review found that current available published studies show methodological shortcomings impairing validation of the effectiveness of self-management interventions on mortality, all-cause hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure.

Practice implications: Further research should determine independent effects of self-management interventions and different combinations of interventions on clinical and patient reported outcomes.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Delphi Technique
  • Global Health
  • Heart Failure / mortality*
  • Heart Failure / prevention & control
  • Hospitalization / statistics & numerical data
  • Humans
  • Patient Readmission / statistics & numerical data*
  • Program Evaluation
  • Psychometrics
  • Quality of Life*
  • Risk Assessment
  • Risk Factors
  • Self Care*
  • Treatment Outcome