RT Journal Article
T1 What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis.
A1 Jonkman, Nini H
A1 Westland, Heleen
A1 Groenwold, Rolf H H
A1 Ågren, Susanna
A1 Anguita, Manuel
A1 Blue, Lynda
A1 Bruggink-André de la Porte, Pieta W F
A1 DeWalt, Darren A
A1 Hebert, Paul L
A1 Heisler, Michele
A1 Jaarsma, Tiny
A1 Kempen, Gertrudis I J M
A1 Leventhal, Marcia E
A1 Lok, Dirk J A
A1 Mårtensson, Jan
A1 Muñiz, Javier
A1 Otsu, Haruka
A1 Peters-Klimm, Frank
A1 Rich, Michael W
A1 Riegel, Barbara
A1 Strömberg, Anna
A1 Tsuyuki, Ross T
A1 Trappenburg, Jaap C A
A1 Schuurmans, Marieke J
A1 Hoes, Arno W
K1 Heart failure
K1 individual patient data meta-analysis
K1 self-management
AB 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.
YR 2016
FD 2016-06-30
LK http://hdl.handle.net/10668/10236
UL http://hdl.handle.net/10668/10236
LA en
DS RISalud
RD Apr 7, 2025