The Dutch institute for Healthcare Improvement, CBO, Utrecht, The Netherlands.
Patient Educ Couns. 2010 Mar;78(3):297-315. doi: 10.1016/j.pec.2010.01.016. Epub 2010 Mar 3.
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.
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.
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.
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.
Further research should determine independent effects of self-management interventions and different combinations of interventions on clinical and patient reported outcomes.
本综述旨在评估与常规护理相比，自我管理干预对慢性心力衰竭患者死亡率、全因住院再入院率、慢性心力衰竭住院率和生活质量的影响。
系统检索了 1996 年至 2009 年间 MEDLINE、EMBASE、CINAHL 和 Cochrane 图书馆的文献。纳入了评估针对慢性心力衰竭患者设计的自我管理干预措施的随机对照试验。主要结局指标包括死亡率、全因住院再入院率、慢性心力衰竭住院率和生活质量。
共确定了 19 项随机对照试验。心力衰竭管理项目启动自我管理干预措施对慢性心力衰竭患者的效果表明，尽管并不总是显著，但对减少全因住院再入院患者人数、降低死亡率和提高生活质量有积极影响。
本系统综述发现，目前已发表的研究存在方法学上的缺陷，影响了自我管理干预对慢性心力衰竭患者死亡率、全因住院再入院率、慢性心力衰竭住院率和生活质量的有效性的验证。
进一步的研究应确定自我管理干预措施的独立效果以及不同干预措施组合对临床和患者报告结局的影响。
