How to research the mechanisms of non-pharmacological cardiac interventions

Clark, Alexander M.; Thirsk, Lorraine M.; Wiens, Kelly S.; Ski, Chantal F.

doi:10.1016/j.ijcard.2015.08.114

Cited by 6 publications

(10 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 Our findings support the notion that effectiveness of self-management interventions may not be attributable to specific program characteristics, but rather that certain types of interventions show a pattern of effects which is dependent on the context in which the intervention is delivered. 62 …”

Section: Discussionmentioning

confidence: 99%

What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis

Jonkman

Westland

Ågren

et al. 2016

Journal of Cardiac Failure

138

115

View full text Add to dashboard Cite

Background 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. Methods and Results 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%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. Conclusion 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.

show abstract

Section: Discussionmentioning

confidence: 99%

What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis

Jonkman

Westland

Ågren

et al. 2016

Journal of Cardiac Failure

138

115

View full text Add to dashboard Cite

show abstract

“…Learning from negative trial results is useful and important but has been uncommon . As complex interventions, concerted efforts are needed to both describe and understand the nature and effects of programmes and heterogeneity and how outcomes are influenced by both context and intervention mechanisms …”

Section: Future Research Prioritiesmentioning

confidence: 99%

“…Simplistic questions of ‘which interventions work?’ – often associated with catchy study acronyms ‐ should be replaced by research which unpacks the complexities of how factors associated with programmes, people and places interact to influence outcomes; in short to address ‘what works for whom, when and why?’ . This more nuanced approach to designing, implementing and evaluating interventions should utilize mixed quantitative and qualitative methods …”

Section: Future Research Prioritiesmentioning

confidence: 99%

“…18 As complex interventions, concerted efforts are needed to both describe and understand the nature and effects of programmes and heterogeneity 4 and how outcomes are influenced by both context 19 and intervention mechanisms. 7,20,21 Simplistic questions of 'which interventions work?' 22 often associated with catchy study acronyms -should be replaced by research which unpacks the complexities of how factors associated with programmes, people and places interact to influence outcomes; in short to address 'what works for whom, when and why?'.…”

Section: Future Research Prioritiesmentioning

confidence: 99%

“…[15][16][17]19 This more nuanced approach to designing, implementing and evaluating interventions should utilize mixed quantitative and qualitative methods. 4,[15][16][17][18][19][20][21] Instead of dismissing inconsistencies in programmes and simply attributing these variations to intervention fidelity, research into programmes should investigate variations in outcomes by exploring programme mechanisms and contexts. 19 For example, although research into intervention mechanisms is large and growing in research volume, 23 review approaches, 24 frameworks 25 and methods, 26 there is an absence of detailed primary studies in heart failure management.…”

Section: Future Research Prioritiesmentioning

confidence: 99%

See 2 more Smart Citations