Efficacy of Nurse-Led and Multidisciplinary Self-Management Programmes for Heart Failure with Reduced Ejection Fraction: An Umbrella Systematic Review.

Chronic disease self-management (CDSM) programmes are widely recommended for heart failure with reduced ejection fraction (HFrEF), yet evidence on their effectiveness remains mixed. This systematic review synthesises the evidence and critically appraises the findings from multiple systematic reviews on CDSM for congestive heart failure (CHF) with a focus on the impact of nurse-led and multidisciplinary CDSM interventions in adults with HFrEF. Systematic review using PRISMA 2020 and AMSTAR-2 guidelines. We searched MEDLINE, Embase, CINAHL, Cochrane Library, and other sources for reviews published from 2012 to 2024. Included were systematic reviews of CDSM interventions for adults diagnosed with HFrEF, focusing on mortality, hospital readmissions, quality of life, and self-management behaviours. A total of 1050 studies were screened, with 60 studies being counted in the final analysis, including 22 reviews of high quality. Evidence for mortality benefit was limited and inconsistent across reviews. However, moderate-to-high-certainty evidence showed that nurse-led CDSM interventions improved hospital readmission rates and health-related quality of life (HRQoL). Improvements in self-management behaviours such as medication adherence and symptom monitoring were also frequently reported. While evidence for a mortality benefit remains inconclusive, this review highlights consistent benefits of nurse-led CDSM interventions in reducing readmissions and improving HRQoL for HFrEF patients. Future research should prioritise standardised outcome reporting, incorporate economic evaluations, and explore patient-centred and culturally tailored approaches to intervention design. PROSPERO registration number CRD42023431539.