Jonkman, Nini HWestland, HeleenGroenwold, Rolf H HÅgren, SusannaAnguita, ManuelBlue, LyndaBruggink-André de la Porte, Pieta W FDeWalt, Darren AHebert, Paul LHeisler, MicheleJaarsma, TinyKempen, Gertrudis I J MLeventhal, Marcia ELok, Dirk J AMårtensson, JanMuñiz, JavierOtsu, HarukaPeters-Klimm, FrankRich, Michael WRiegel, BarbaraStrömberg, AnnaTsuyuki, Ross TTrappenburg, Jaap C ASchuurmans, Marieke JHoes, Arno W2023-01-252023-01-252016-06-30http://hdl.handle.net/10668/10236To 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.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Heart failureindividual patient data meta-analysisself-managementAgedCause of DeathFemaleHeart FailureHospitalizationHumansMaleMiddle AgedProportional Hazards ModelsQuality of LifeRandomized Controlled Trials as TopicRetrospective StudiesSelf-ManagementSeverity of Illness IndexSurvival AnalysisTreatment OutcomeUnited Statesresearch article27374838open access10.1016/j.cardfail.2016.06.4221532-8414PMC5180428http://www.onlinejcf.com/article/S1071916416305474/pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5180428/pdf