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What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis.
- Source :
- Journal of Cardiac Failure; Nov2016, Vol. 22 Issue 11, p861-871, 11p
- Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>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.<bold>Methods and Results: </bold>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.<bold>Conclusion: </bold>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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10719164
- Volume :
- 22
- Issue :
- 11
- Database :
- Supplemental Index
- Journal :
- Journal of Cardiac Failure
- Publication Type :
- Academic Journal
- Accession number :
- 119175345
- Full Text :
- https://doi.org/10.1016/j.cardfail.2016.06.422