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护士主导的心力衰竭诊所的有效性:一项系统评价。

Effectiveness of nurse-led heart failure clinic: A systematic review.

作者信息

Wu Xiaoxiao, Li Zhen, Tian Qingxiu, Ji Shiming, Zhang Chen

机构信息

Nursing Department, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Nursing Department, Peking Union Medical College Hospital, Beijing, China.

出版信息

Int J Nurs Sci. 2024 Apr 18;11(3):315-329. doi: 10.1016/j.ijnss.2024.04.001. eCollection 2024 Jul.


DOI:10.1016/j.ijnss.2024.04.001
PMID:39156682
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11329041/
Abstract

OBJECTIVES: Heart failure is a stage of various cardiovascular diseases and constitutes a growing major public health problem worldwide. Nurse-led heart failure clinics play an important role in managing heart failure. All nurse-led heart failure clinic services are clinic-based. We conducted a systematic review to describe the contents and impact of nurse-led heart failure clinics. METHODS: A review of nurse-led heart failure clinic research was undertaken in PubMed, Embase, Web of Science, and Cochrane Library. The search was initially conducted on October 23, 2022 and updated on November 21, 2023. Articles were appraised using the Joanna Briggs Institute Appraisal criteria by two independent reviewers. This review was registered on PROSPERO (CRD42022352209). RESULTS: Twelve articles were included in this systematic review. The nurse-led heart failure clinic contents were: medication uptitration, educational counselling, evidence-based transitional care, psychosocial support, physical examination and mental well-being assessment, therapy monitoring and adjustment, follow-up, and phone consultations. Most studies reported largely positive clinical outcomes in nurse-led heart failure clinics. Four studies examined the quality of life and reported conflicting results; four studies examined medication titration efficacy, and the results were generally positive. Only two studies examined cost-effectiveness. CONCLUSIONS: Nurse-led heart failure clinics have shown a largely positive impact on patient outcomes, quality of life, and medication titration efficacy. More randomised controlled trials and other studies are needed to obtain more robust conclusions.

摘要

目的:心力衰竭是各种心血管疾病的一个阶段,在全球范围内构成日益严重的重大公共卫生问题。由护士主导的心力衰竭诊所在心力衰竭管理中发挥着重要作用。所有由护士主导的心力衰竭诊所服务均以门诊为基础。我们进行了一项系统评价,以描述由护士主导的心力衰竭诊所的内容和影响。 方法:在PubMed、Embase、科学网和考克兰图书馆对由护士主导的心力衰竭诊所研究进行了综述。检索最初于2022年10月23日进行,并于2023年11月21日更新。由两名独立评审员使用乔安娜·布里格斯研究所的评价标准对文章进行评价。本综述已在国际前瞻性系统评价注册库(CRD42022352209)登记。 结果:本系统评价纳入了12篇文章。由护士主导的心力衰竭诊所的内容包括:药物滴定、教育咨询、循证过渡护理、心理社会支持、体格检查和心理健康评估、治疗监测和调整、随访以及电话咨询。大多数研究报告称,由护士主导的心力衰竭诊所的临床结果总体呈阳性。四项研究考察了生活质量,报告结果相互矛盾;四项研究考察了药物滴定疗效,结果总体呈阳性。只有两项研究考察了成本效益。 结论:由护士主导的心力衰竭诊所已显示出对患者预后、生活质量和药物滴定疗效产生了总体积极影响。需要更多的随机对照试验和其他研究来得出更有力的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1bc/11329041/bd17fa578a84/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1bc/11329041/bd17fa578a84/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1bc/11329041/bd17fa578a84/gr1.jpg

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本文引用的文献

[1]
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

Circulation. 2022-5-3

[2]
2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.

Eur Heart J. 2021-9-21

[3]
An Interprofessional Collaborative Practice Can Reduce Heart Failure Hospital Readmissions and Costs in an Underserved Population.

J Card Fail. 2021-11

[4]
2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee.

J Am Coll Cardiol. 2021-2-16

[5]
Effectiveness of nurse-led clinics in the early discharge period after percutaneous coronary intervention: A systematic review.

Aust Crit Care. 2021-9

[6]
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J Am Coll Cardiol. 2021-4-27

[7]
Epidemiology of heart failure.

Eur J Heart Fail. 2020-8

[8]
Quality of life of chronic heart failure patients: a systematic review and meta-analysis.

Heart Fail Rev. 2020-11

[9]
Nurse-Led Heart Failure Clinics Are Associated With Reduced Mortality but Not Heart Failure Hospitalization.

J Am Heart Assoc. 2019-5-21

[10]
Introducing nurse-led heart failure clinics in Swedish primary care settings.

Eur J Heart Fail. 2018-10-19

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