Elements of nonpharmacologic interventions that prevent progression of heart failure: a meta-analysis.
This review examined whether nonpharmacologic treatment was associated with reductions in all-cause mortality and heart failure (HF) hospitalizations and investigated the effects of face-to-face contact and longer treatment duration on these outcomes. MEDLINE and PsycINFO databases were searched through June 2006 and bibliographies of potential articles were hand-searched. Nonpharmacologic treatment was associated with significantly lower odds of HF hospitalizations (odds ratio [OR], 0.41; 95% confidence interval [CI], 0.30-0.56) and death (OR, 0.69; 95% CI, 0.56-0.85) compared with control treatment. Face-to-face contact was associated with significantly lower odds of HF hospitalization (OR, 0.42; 95% CI, 0.22-0.81; P<.05) and death (OR, 0.63; 95% CI, 0.44-0.91; P<.05) as compared with control treatment. Longer treatment duration (>or=12 months) was associated with a 65% reduction in the rate of HF hospitalizations and a 36% reduction in death rate. Nonpharmacologic treatment featuring face-to-face contact is particularly effective in reducing HF hospitalization and all-cause mortality rates.
Kozak
Andrea T
AT
Department of Preventive Medicine Northwestern University, Chicago, IL, USA. kozak@oakland.edu
Rucker-Whitaker
Cheryl
C
Basu
Sanjib
S
Mendes de Leon
Carlos F
CF
Calvin
James E
JE
Grady
Kathleen L
KL
Richardson
DeJuran
D
Powell
Lynda H
LH
D003142:Communication; D018450:Disease Progression; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D010817:Physician-Patient Relations; D011379:Prognosis; D012017:Referral and Consultation; D016896:Treatment Outcome