A systematic review and meta-analysis of the effect of transitional care interventions on the prognosis of patients with heart failure.

BACKGROUND

The purpose of this study was to explore the impact of transitional care interventions on the prognosis of patients with heart failure.

METHODS

Literature on transitional care interventions in patients with heart failure were retrieved from PubMed, Medline, Embase, and CENTRAL databases. The literature retrieval date was October 12, 2021. The inclusion criteria were based on PICOS principles. A researcher independently extracted information from the literature included in the meta-analysis, including author, title, publication date, patient baseline information, intervention measures, and observation indicators. Two other researchers checked the extracted data. Cochrane bias risk assessment was used to evaluate the quality of the included study. The chi-square test was used for heterogeneity test. Egger test was used for publication bias test. Data were statistically analyzed using Cochrane software RevMan 5.3. The Chi-square test was used to assess heterogeneity. The odds ratio (OR) and 95% confidence interval (CI) were used to describe the count data statistically.

RESULTS

A total of 567 related articles were retrieved, and 18 studies were further screened for meta-analysis, 13 with low risk of overall bias, and 5 with high risk of overall bias. A total of 4,123 patients with heart failure were included, comprising 1,914 patients receiving transitional care interventions (46.42%) and 2,209 patients receiving routine care interventions (53.58%). The readmission rate of heart failure in patients receiving transitional care interventions was lower than that of patients receiving routine care interventions. There was heterogeneity among the literatures, and the source analysis of heterogeneity showed that the results were stable, and the random effect model was adopted without publication bias. The emergency visit rate of patients with heart failure receiving transitional care interventions was lower than that of patients receiving usual care interventions. There was no significant difference in mortality between patients receiving transitional care interventions and patients receiving usual care interventions.

DISCUSSION

Transitional care interventions can reduce the rate of patient readmission and emergency visits but have no significant impact on the mortality of patients. This study suggests the establishment of a transitional care intervention system for patients with heart failure.