Effectiveness of a follow-up program for elderly heart failure patients after hospital discharge. A randomized controlled trial

Guerrero, José L.; Alonso-Fernández, Teresa; García-Mayolín, N.; Gusi, Narcís; Ribera-Casado, José Manuel

doi:10.1016/j.eurger.2014.05.005

Cited by 14 publications

(30 citation statements)

References 22 publications

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“…All‐cause mortality and/or all‐cause hospitalizations were secondary outcome measures in four studies respectively, and one study employed an all‐cause/HF composite as a secondary objective. In the studies measuring mortality, three reported a significant improvement . The proportion of HFpEF patients in these studies was 67%, 47%, and 27%, respectively.…”

Section: Resultsmentioning

confidence: 92%

“…In the studies measuring mortality, three reported a significant improvement . The proportion of HFpEF patients in these studies was 67%, 47%, and 27%, respectively. Of these studies, only Stewart et al .…”

Section: Resultsmentioning

confidence: 92%

“…Only three reported a statistically significant result. 24,34,35 The remainder reported either no impact [17][18][19][20]27,30,33 ; positive trends in favour of the intervention such as shorter hospital stays, prolonged time to hospitalization, and lower total numbers hospitalized 22,32 ; or trends towards higher hospitalizations in intervention groups. 23,28,29 The effect of disease management programmes on self-care Nine studies evaluated the effect of the intervention on selfcare.…”

Section: The Effect Of Disease Management Programmes On Hospitalizationsmentioning

confidence: 99%

“…All of the interventions were directed to patients, with three including carers. Eleven of the study interventions were delivered primarily by nurses with relevant experience or additional training, 17,20,21,25,26,[28][29][30][31]33,34 six were multi-disciplinary, 18,19,22,27,32,35 and in one, it was unclear. 23 All studies included some component of education, behavioural or psychosocial support, and self-management support.…”

Section: Interventions and Study Characteristicsmentioning

confidence: 99%

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Heart failure disease management: a systematic review of effectiveness in heart failure with preserved ejection fraction

et al. 2020

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Aims Heart failure with preserved ejection fraction (HFpEF) poses a substantial challenge for clinicians, but there is little guidance for effective management. The aim of this systematic review was to determine if there was evidence that disease management programmes (DMPs) improved outcomes for patients with HFpEF. Methods and results A systematic review of controlled studies in English or Greek of DMPs including patients with HFpEF from 2008 to 2018 was conducted using CINAHL, Cochrane, MEDLINE, and Embase. Interventions were assessed using a DMP taxonomy and scored for complexity and intensity. Bias was assessed using the Cochrane Collaboration tool. Initial and updated searches found 6089 titles once duplicates were removed. The final analysis included 18 studies with 5435 HF patients: 1866 patients (34%, study ranges 18–100%) had potential HFpEF (limited by variable definitions). Significant heterogeneity in terms of the population, intervention, comparisons, and outcomes prohibited meta‐analysis. Statistically significant or positive trends were found in mortality, hospitalization rates, self‐care ability, quality of life, anxiety, depression, and sleep, but findings were not robust or consistent. Four studies reported results separately for study‐defined HFpEF, with two finding less positive effect on outcomes. Conclusions Varying definitions of HFpEF used in studies are a substantial limitation in interpretation of findings. The reduced efficacy noted in contemporary HF DMP studies may not only be due to improvements in usual care but may also reflect inclusion of heterogeneous patients with HFpEF or HF with mid‐range EF who may not respond in the same way as HFrEF to individual components. Given that patients with HFpEF are older and multi‐morbid, DMPs targeting HFpEF should not rely on a single‐disease focus but provide care that addresses predisposing and presentation phenotypes and draws on the principles of comprehensive geriatric assessment. Other components could also be more targeted to HFpEF such as modification of lifestyle factors for which there is emerging evidence, rather than simply continuing the model of care used in HFrEF. Based on current evidence, HF DMPs may improve mortality, hospitalization rates, self‐care, and quality of life in patients with HFpEF; however, further research specifically tailored to appropriately defined HFpEF is required.

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Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 92%

Section: The Effect Of Disease Management Programmes On Hospitalizationsmentioning

confidence: 99%

Section: Interventions and Study Characteristicsmentioning

confidence: 99%

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Heart failure disease management: a systematic review of effectiveness in heart failure with preserved ejection fraction

et al. 2020

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“…This secondary analysis of a previously published randomized controlled trial comparing the effectiveness of a DMP with usual care in elderly adults with HF examined whether the intervention was effective in increasing event‐free survivals (defined as the time elapsed until the first readmission or until death of the individual from any cause during the study period) in individuals with cognitive impairment.…”

mentioning

confidence: 99%