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.
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.


CONCLUSIONS
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.


CONCLUSIONS
Further research should determine independent effects of self-management interventions and different combinations of interventions on clinical and patient reported outcomes.
Ditewig
Joanne B
JB
The Dutch institute for Healthcare Improvement, CBO, Utrecht, The Netherlands. jb.ditewig@gmail.com
Blok
Helene
H
Havers
Jeroen
J
van Veenendaal
Haske
H
D003697:Delphi Technique; D014943:Global Health; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015397:Program Evaluation; D011594:Psychometrics; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012648:Self Care; D016896:Treatment Outcome