%0 Journal Article
%A Jonkman, Nini H
%A Westland, Heleen
%A Groenwold, Rolf H H
%A Ågren, Susanna
%A Anguita, Manuel
%A Blue, Lynda
%A Bruggink-André de la Porte, Pieta W F
%A DeWalt, Darren A
%A Hebert, Paul L
%A Heisler, Michele
%A Jaarsma, Tiny
%A Kempen, Gertrudis I J M
%A Leventhal, Marcia E
%A Lok, Dirk J A
%A Mårtensson, Jan
%A Muñiz, Javier
%A Otsu, Haruka
%A Peters-Klimm, Frank
%A Rich, Michael W
%A Riegel, Barbara
%A Strömberg, Anna
%A Tsuyuki, Ross T
%A Trappenburg, Jaap C A
%A Schuurmans, Marieke J
%A Hoes, Arno W
%T What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis.
%D 2016
%U http://hdl.handle.net/10668/10236
%X 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% 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. 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.
%K Heart failure
%K individual patient data meta-analysis
%K self-management
%~