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Meta-Analysis
. 2019 Jan 8;1(1):CD002752.
doi: 10.1002/14651858.CD002752.pub4.

Disease management interventions for heart failure

Andrea Takeda  1 , Nicole Martin, Rod S Taylor, Stephanie Jc Taylor
Affiliations
Meta-Analysis

Disease management interventions for heart failure

Andrea Takeda et al. Cochrane Database Syst Rev. .

Abstract

Background: Despite advances in treatment, the increasing and ageing population makes heart failure an important cause of morbidity and death worldwide. It is associated with high healthcare costs, partly driven by frequent hospital readmissions. Disease management interventions may help to manage people with heart failure in a more proactive, preventative way than drug therapy alone. This is the second update of a review published in 2005 and updated in 2012.

Objectives: To compare the effects of different disease management interventions for heart failure (which are not purely educational in focus), with usual care, in terms of death, hospital readmissions, quality of life and cost-related outcomes.

Search methods: We searched CENTRAL, MEDLINE, Embase and CINAHL for this review update on 9 January 2018 and two clinical trials registries on 4 July 2018. We applied no language restrictions.

Selection criteria: We included randomised controlled trials (RCTs) with at least six months' follow-up, comparing disease management interventions to usual care for adults who had been admitted to hospital at least once with a diagnosis of heart failure. There were three main types of intervention: case management; clinic-based interventions; multidisciplinary interventions.

Data collection and analysis: We used standard methodological procedures expected by Cochrane. Outcomes of interest were mortality due to heart failure, mortality due to any cause, hospital readmission for heart failure, hospital readmission for any cause, adverse effects, quality of life, costs and cost-effectiveness.

Main results: We found 22 new RCTs, so now include 47 RCTs (10,869 participants). Twenty-eight were case management interventions, seven were clinic-based models, nine were multidisciplinary interventions, and three could not be categorised as any of these. The included studies were predominantly in an older population, with most studies reporting a mean age of between 67 and 80 years. Seven RCTs were in upper-middle-income countries, the rest were in high-income countries.Only two multidisciplinary-intervention RCTs reported mortality due to heart failure. Pooled analysis gave a risk ratio (RR) of 0.46 (95% confidence interval (CI) 0.23 to 0.95), but the very low-quality evidence means we are uncertain of the effect on mortality due to heart failure. Based on this limited evidence, the number needed to treat for an additional beneficial outcome (NNTB) is 12 (95% CI 9 to 126).Twenty-six case management RCTs reported all-cause mortality, with low-quality evidence indicating that these may reduce all-cause mortality (RR 0.78, 95% CI 0.68 to 0.90; NNTB 25, 95% CI 17 to 54). We pooled all seven clinic-based studies, with low-quality evidence suggesting they may make little to no difference to all-cause mortality. Pooled analysis of eight multidisciplinary studies gave moderate-quality evidence that these probably reduce all-cause mortality (RR 0.67, 95% CI 0.54 to 0.83; NNTB 17, 95% CI 12 to 32).We pooled data on heart failure readmissions from 12 case management studies. Moderate-quality evidence suggests that they probably reduce heart failure readmissions (RR 0.64, 95% CI 0.53 to 0.78; NNTB 8, 95% CI 6 to 13). We were able to pool only two clinic-based studies, and the moderate-quality evidence suggested that there is probably little or no difference in heart failure readmissions between clinic-based interventions and usual care (RR 1.01, 95% CI 0.87 to 1.18). Pooled analysis of five multidisciplinary interventions gave low-quality evidence that these may reduce the risk of heart failure readmissions (RR 0.68, 95% CI 0.50 to 0.92; NNTB 11, 95% CI 7 to 44).Meta-analysis of 14 RCTs gave moderate-quality evidence that case management probably slightly reduces all-cause readmissions (RR 0.92, 95% CI 0.83 to 1.01); a decrease from 491 to 451 in 1000 people (95% CI 407 to 495). Pooling four clinic-based RCTs gave low-quality and somewhat heterogeneous evidence that these may result in little or no difference in all-cause readmissions (RR 0.90, 95% CI 0.72 to 1.12). Low-quality evidence from five RCTs indicated that multidisciplinary interventions may slightly reduce all-cause readmissions (RR 0.85, 95% CI 0.71 to 1.01); a decrease from 450 to 383 in 1000 people (95% CI 320 to 455).Neither case management nor clinic-based intervention RCTs reported adverse effects. Two multidisciplinary interventions reported that no adverse events occurred. GRADE assessment of moderate quality suggested that there may be little or no difference in adverse effects between multidisciplinary interventions and usual care.Quality of life was generally poorly reported, with high attrition. Low-quality evidence means we are uncertain about the effect of case management and multidisciplinary interventions on quality of life. Four clinic-based studies reported quality of life but we could not pool them due to differences in reporting. Low-quality evidence indicates that clinic-based interventions may result in little or no difference in quality of life.Four case management programmes had cost-effectiveness analyses, and seven reported cost data. Low-quality evidence indicates that these may reduce costs and may be cost-effective. Two clinic-based studies reported cost savings. Low-quality evidence indicates that clinic-based interventions may reduce costs slightly. Low-quality data from one multidisciplinary intervention suggested this may be cost-effective from a societal perspective but less so from a health-services perspective.

Authors' conclusions: We found limited evidence for the effect of disease management programmes on mortality due to heart failure, with few studies reporting this outcome. Case management may reduce all-cause mortality, and multidisciplinary interventions probably also reduce all-cause mortality, but clinic-based interventions had little or no effect on all-cause mortality. Readmissions due to heart failure or any cause were probably reduced by case-management interventions. Clinic-based interventions probably make little or no difference to heart failure readmissions and may result in little or no difference in readmissions for any cause. Multidisciplinary interventions may reduce the risk of readmission for heart failure or for any cause. There was a lack of evidence for adverse effects, and conclusions on quality of life remain uncertain due to poor-quality data. Variations in study location and time of occurrence hamper attempts to review costs and cost-effectiveness.The potential to improve quality of life is an important consideration but remains poorly reported. Improved reporting in future trials would strengthen the evidence for this patient-relevant outcome.

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Conflict of interest statement

AT: none known

NM: none known

RT: none known

ST: none known

Figures

1
1
Study flow diagram for 2018 update
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study
3
3
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
4
4
Funnel plot of comparison 1. Case management vs usual care, outcome: 1.1 All‐cause mortality ‐ main analysis
5
5
Funnel plot of comparison 1. Case management vs usual care, outcome: 1.5 HF readmissions ‐ main analysis
6
6
Funnel plot of comparison 1. Case management vs usual care, outcome: 1.9 All‐cause readmissions ‐ main analysis
7
7
Funnel plot of comparison 1. Case management vs usual care, outcome: 1.13 Quality of life (MLHFQ mean score at end of follow‐up)
1.1
1.1. Analysis
Comparison 1 Case management vs usual care, Outcome 1 All‐cause mortality ‐ main analysis.
1.2
1.2. Analysis
Comparison 1 Case management vs usual care, Outcome 2 All‐cause mortality ‐ subgroup analysis by length of follow‐up.
1.3
1.3. Analysis
Comparison 1 Case management vs usual care, Outcome 3 All‐cause mortality ‐ subgroup analysis by person delivering the intervention.
1.4
1.4. Analysis
Comparison 1 Case management vs usual care, Outcome 4 All‐cause mortality ‐ sensitivity analysis with low risk of bias.
1.5
1.5. Analysis
Comparison 1 Case management vs usual care, Outcome 5 HF readmissions ‐ main analysis.
1.6
1.6. Analysis
Comparison 1 Case management vs usual care, Outcome 6 HF readmissions ‐ subgroup analysis by length of follow‐up.
1.7
1.7. Analysis
Comparison 1 Case management vs usual care, Outcome 7 HF readmissions ‐ subgroup analysis by person delivering the intervention.
1.8
1.8. Analysis
Comparison 1 Case management vs usual care, Outcome 8 HF readmissions ‐ sensitivity analysis with low risk of bias.
1.9
1.9. Analysis
Comparison 1 Case management vs usual care, Outcome 9 All‐cause readmissions ‐ main analysis.
1.10
1.10. Analysis
Comparison 1 Case management vs usual care, Outcome 10 All‐cause readmissions ‐ subgroup analysis by length of follow‐up.
1.11
1.11. Analysis
Comparison 1 Case management vs usual care, Outcome 11 All‐cause readmissions ‐ subgroup analysis by person delivering the intervention.
1.12
1.12. Analysis
Comparison 1 Case management vs usual care, Outcome 12 All‐cause readmissions ‐ sensitivity analysis with low risk of bias.
1.13
1.13. Analysis
Comparison 1 Case management vs usual care, Outcome 13 Quality of life (MLHFQ mean score at end of follow‐up).
1.14
1.14. Analysis
Comparison 1 Case management vs usual care, Outcome 14 Quality of life (subgroup by length of intervention).
1.15
1.15. Analysis
Comparison 1 Case management vs usual care, Outcome 15 Quality of life (subgroup by person delivering intervention).
2.1
2.1. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 1 All‐cause mortality ‐ main analysis.
2.2
2.2. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 2 All‐cause mortality ‐ subgroup analysis by length of follow‐up.
2.3
2.3. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 3 All‐cause mortality ‐ subgroup analysis by person delivering the intervention.
2.4
2.4. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 4 All‐cause mortality ‐ sensitivity analysis with low risk of bias.
2.5
2.5. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 5 All‐cause mortality ‐ sensitivity analysis without cluster‐RCT.
2.6
2.6. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 6 HF readmissions ‐ main analysis.
2.7
2.7. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 7 HF readmissions ‐ subgroup analysis by person delivering the intervention.
2.8
2.8. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 8 HF readmissions ‐ subgroup analysis by length of follow‐up.
2.9
2.9. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 9 All‐cause readmissions.
2.10
2.10. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 10 All‐cause readmissions ‐ subgroup analysis by length of follow‐up.
2.11
2.11. Analysis
Comparison 2 Clinic‐based intervention vs usual care, Outcome 11 All‐cause readmissions ‐ subgroup analysis by person delivering the intervention.
3.1
3.1. Analysis
Comparison 3 Multidisciplinary vs usual care, Outcome 1 HF mortality ‐ main analysis.
3.2
3.2. Analysis
Comparison 3 Multidisciplinary vs usual care, Outcome 2 All‐cause mortality ‐ main analysis.
3.3
3.3. Analysis
Comparison 3 Multidisciplinary vs usual care, Outcome 3 All‐cause mortality ‐ subgroup analysis by length of follow‐up.
3.4
3.4. Analysis
Comparison 3 Multidisciplinary vs usual care, Outcome 4 All‐cause mortality ‐ sensitivity analysis with low risk of bias.
3.5
3.5. Analysis
Comparison 3 Multidisciplinary vs usual care, Outcome 5 HF readmissions ‐ main analysis.
3.6
3.6. Analysis
Comparison 3 Multidisciplinary vs usual care, Outcome 6 HF readmissions ‐ subgroup analysis by length of follow‐up.
3.7
3.7. Analysis
Comparison 3 Multidisciplinary vs usual care, Outcome 7 All‐cause readmissions ‐ main analysis.
3.8
3.8. Analysis
Comparison 3 Multidisciplinary vs usual care, Outcome 8 All‐cause readmissions ‐ subgroup analysis by length of follow‐up.
3.9
3.9. Analysis
Comparison 3 Multidisciplinary vs usual care, Outcome 9 Quality of life ‐ MLHFQ.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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Capomolla 2002 {published data only}
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Chen 2018 {published data only}
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Cline 1998 {published data only}
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DeBusk 2004 {published data only}
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Del Sindaco 2007 {published data only}
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de Souza 2014 {published and unpublished data}
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Doughty 2002 {published data only}
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Ducharme 2005 {published data only}
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Dunbar 2014 {published and unpublished data}
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Gonzalez‐Guerrero 2014 {published data only}
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Holland 2007 {published data only}
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Jaarsma 2000 {published data only}
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Jaarsma 2008 {published data only}
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Kasper 2002 {published data only}
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Kimmelstiel 2004 {published data only}
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Krumholz 2002 {published data only}
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Kwok 2008 {published data only}
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Lang 2018 {published data only}
    1. Eyre V, Lang CC, Smith K, Jolly K, Davis R, Hayward C, et al. Rehabilitation enablement in chronic heart failure: a facilitated self‐care rehabilitation intervention in patients with heart failure with preserved ejection fraction (REACH‐HFpEF) and their caregivers: rationale and protocol for a single‐centre pilot randomised controlled trial. BMJ Open 2016;6(10):e012853. - PMC - PubMed
    1. Lang CC, Smith K, Wingham J, Eyre V, Greaves CJ, Warren FC, et al. A randomised controlled trial of a facilitated home‐based rehabilitation intervention in patients with heart failure with preserved ejection fraction and their caregivers: the REACH‐HFpEFPilot Study. BMJ Open 2018;8:1‐12. [DOI: 10.1136/bmjopen-2017-019649] - DOI - PMC - PubMed
Leventhal 2011 {published data only}
    1. Leventhal ME, Denhaerynck K, Brunner‐La Rocca HP, Burnand B, Conca‐Zeller A, Bernasconi AT, et al. Swiss Interdisciplinary Management Programme for Heart Failure (SWIM‐HF): a randomised controlled trial study of an outpatient inter‐professional management programme for heart failure patients in Switzerland. Swiss Medical Weekly 2011;141:w13171‐9. - PubMed
Lopez 2006 {published data only}
    1. Lopez CC, Falces SC, Cubi QD, Arnau BA, Ylla BM, Muro PN, et al. Randomized clinical trial of a postdischarge pharmaceutical care program vs. regular follow‐up in patients with heart failure. Farmacia Hospitalaria 2006;30(6):328‐42. - PubMed
Mao 2015 {published data only}
    1. Mao CT, Liu MH, Hsu KH, Fu TC, Wang JS, Huang YY, et al. Effect of multidisciplinary disease management for hospitalized heart failure under a national health insurance programme. Journal of Cardiovascular Medicine 2015;16(9):616‐24. - PubMed
    1. NCT01416285. Impact of heart failure center program on cardiac outcomes in patients with heart failure. clinicaltrials.gov/ct2/show/NCT01416285 (first posted 15 August 2011).
Mehralian 2014 {published data only}
    1. Mehralian H, Salehi S, Moghaddasi J, Amiri M, Rafiei H. The comparison of the effects of education provided by nurses on the quality of life in patients with congestive heart failure (CHF) in usual and home‐visit cares in Iran. Global Journal of Health Sciences 2014;6(3):256‐60. - PMC - PubMed
Mejhert 2004 {published data only}
    1. Karlsson MR, Edner M, Henriksson P, Mejhert M, Persson H, Grut M, et al. A nurse‐based management program in heart failure patients affects females and persons with cognitive dysfunction most. Patient Education & Counseling 2005;58(2):146‐53. - PubMed
    1. Mejhert M, Kahan T, Persson H, Edner M. Limited long term effects of a management programme for heart failure. Heart (British Cardiac Society) 2004;90(9):1010‐5. - PMC - PubMed
Naylor 2004 {published data only}
    1. McCauley KM, Bixby MB, Naylor MD. Advanced practice nurse strategies to improve outcomes and reduce cost in elders with heart failure. Disease Management 2006;9(5):302‐10. - PubMed
    1. Naylor MD, Brooten DA, Campbell RL, Maislin G, McCauley KM, Schwartz JS. Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. Journal of the American Geriatrics Society 2004;52(5):675‐84. - PubMed
Nucifora 2006 {published data only}
    1. Nucifora G, Albanese MC, Biaggio P, Caliandro D, Gregori D, Goss P, et al. Lack of improvement of clinical outcomes by a low‐cost, hospital‐based heart failure management programme. Journal of Cardiovascular Medicine 2006;7(8):614‐22. - PubMed
Ong 2016 {published data only}
    1. Black JT, Romano PS, Sadeghi B, Auerbach AD, Ganiats TG, Greenfield S, et al. A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition ‐ Heart Failure (BEAT‐HF) randomized controlled trial. Trials 2014;15:124. - PMC - PubMed
    1. NCT01360203. Better effectiveness after transition ‐ heart failure (BEAT‐HF). clinicaltrials.gov/ct2/show/NCT01360203 (first posted 25 May 2011).
    1. Ong M, Romano PS, Edgington S, Aronow HU, Auerbach AD, Black JT, et al. Adherence to remote patient monitoring after discharge of hospitalized heart failure patients: the better effectiveness after transition‐heart failure (BEAT‐HF) randomized controlled trial CNO ‐ CN‐01160490. Journal of General Internal Medicine 2016;31(2 SUPPL. 1):S115. - PMC - PubMed
    1. Ong MK, Romano PS, Edgington S, Aronow HU, Auerbach AD, Black JT, et al. Effectiveness of remote patient monitoring after discharge of hospitalized patients with heart failure: the better effectiveness after transition ‐‐ heart failure (BEAT‐HF) randomized clinical trial.[Erratum appears in JAMA Intern Med. 2016 Apr;176(4):568; PMID: 26974880]. JAMA Internal Medicine 2016;176(3):310‐8. - PMC - PubMed
    1. Ong MK, Romano PS, Edgington S, Auerbach AD, Black JT, Escarce JJ, et al. Effectiveness of remote patient monitoring after discharge of hospitalized patients with heart failure: the better effectiveness after transition‐heart failure (BEAT‐HF) randomized clinical trial. Cardiology 2016;134:21. - PMC - PubMed
Rainville 1999 {published data only}
    1. Rainville EC. Impact of pharmacist interventions on hospital re‐admissions for heart failure. American Journal of Health‐System Pharmacy 1999;56:1339‐42. - PubMed
Salehitali 2009 {published data only}
    1. Salehitali S, Dehkordi AH, Hafshejani SMH, Jafarei A. The effect of continuous home visits and health education on the rate of readmissions, referrals, and health care costs among discharged patients with heart failure. HAYAT 2009;15:43‐49.
Shively 2013 {published and unpublished data}
    1. NCT00260650. Patient activation in high‐risk patients with heart failure (Heart PACT). clinicaltrials.gov/ct2/show/NCT00260650 (first posted 1 December 2005).
    1. Shively M, Gardetto N, Kodiath M, Kelly A, Smith T. Effect of patient activation on self‐management behaviors in heart failure. Circulation: Cardiovascular Quality and Outcomes 2011;4(6):no pagination.
    1. Shively MJ, Gardetto NJ, Kodiath MF, Kelly A, Smith TL, Stepnowsky C, et al. Effect of patient activation on self‐management in patients with heart failure. Journal of Cardiovascular Nursing 2013;28:20‐34. - PubMed
Stewart 1999a {published data only}
    1. Stewart S, Horowitz JD. A specialist nurse‐led intervention in Australia. In: Stewart S, Blue L editor(s). Improving outcomes in chronic heart failure: a practical guide to specialist nurse intervention. BMJ Books, 2001.
    1. Stewart S, Marley JE, Horowitz J D. Effects of a multidisciplinary, home‐based intervention on unplanned re‐admissions and survival among patients with chronic congestive heart failure: a randomised controlled study. Lancet 1999;354:1077‐83. - PubMed
Stromberg 2003 {published data only}
    1. Stromberg A, Martensson J, Fridlund B, Levin LA, Karlsson JE, Dahlstrom U. Nurse‐led heart failure clinics improve survival and self‐care behaviour in patients with heart failure: results from a prospective, randomised trial. European Heart Journal 2003;24(11):1014‐23. - PubMed
Thompson 2005 {published data only}
    1. Thompson DR, Roebuck A, Stewart S. Effects of a nurse‐led, clinic and home‐based intervention on recurrent hospital use in chronic heart failure. European Journal of Heart Failure 2005;7(3):377‐84. - PubMed
Tsuchihashi‐Makaya 2013 {published and unpublished data}
    1. NCT01284400. Home‐based disease management program to improve clinical outcomes in patients with heart failure. clinicaltrials.gov/ct2/show/NCT01284400 (first posted 27 January 2011).
    1. Tsuchihashi‐Makaya M, Matsuo H, Kakinoki S, Takechi S, Kinugawa S, Tsutsui H, et al. Home‐based disease management program to improve psychological status in patients with heart failure in Japan. Circulation Journal 2013;77:926‐33. - PubMed
    1. Tsuchihashi‐Makaya M, Matsuo H, Kakinoki S, Takechi S, Tsutsui H, Investigators JH. Rationale and design of the Japanese heart failure outpatients disease management and cardiac evaluation (J‐HOMECARE). Journal of Cardiology 2011;58:165‐72. - PubMed
Tsuyuki 2004 {published data only}
    1. Tsuyuki RT, Fradette M, Johnson JA, Bungard TJ, Eurich DT, Ashton T, et al. A multicenter disease management program for hospitalized patients with heart failure. Journal of Cardiac Failure 2004;10(6 SUPPL):473‐80. - PubMed
Wierzchowiecki 2006 {published data only}
    1. Wierzchowiecki M, Poprawski K, Nowicka A, Kandziora M, Piatkowska A, Jankowiak M, et al. A new programme of multidisciplinary care for patients with heart failure in Poznan: one‐year follow‐up. Kardiologia Polska 2006;64(10):1063‐70. - PubMed
    1. Wierzchowiecki M, Poprawski K, Nowicka A, Kandziora M, Piatkowska A, Jankowiak M, et al. New multidisciplinary heart failure care program (six‐month preliminary observation). Polski Merkuriusz Lekarski 2006;21(126):511‐5. - PubMed
Yu 2015a {published data only}
    1. Yu DS, Lee DT, Stewart S, Thompson DR, Choi KC, Yu CM. Effect of nurse‐implemented transitional care for Chinese individuals with chronic heart failure in Hong Kong: a randomized controlled trial. Journal of the American Geriatrics Society 2015;63(8):1583‐93. - PubMed
    1. Yu DSF, Lee DTF, Stewart S, Thompson DR, Choi KC, Yu CM. The effects of a nurse‐led empowerment‐based disease management program on clinical outcomes, self‐care and health‐related quality of life among Chinese patients with heart failure. European Journal of Heart Failure 2014;16:60.

References to studies excluded from this review

ACTRN12609000442202 {unpublished data only}
    1. ACTRN12609000442202. Use of physiological techniques in heart failure management guidedheart [A randomised controlled trial to assess whether the use of physiologic testing to guide intensity of a Heart Failure Management Program (including the combination of isosorbide mononitrate and hydralazine to the contemporary medical regimen) leads to better outcomes over 2 years follow‐up]. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12609000442202 (date of registration 12 June 2009).
ACTRN12616000099426 {unpublished data only}
    1. ACTRN12616000099426. Evaluating a self‐management program to improve knowledge and self‐care for people with heart failure (HF) in Vietnam [A self‐management program for people with heart failure (HF) to improve knowledge and self‐care in Vietnam: A cluster randomised trial]. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12616000099426 (date of registration 1 February 2016).
ACTRN12616001627448 {unpublished data only}
    1. ACTRN12616001627448. Effect of a model of GP and pharmacist collaboration in primary care in reducing unplanned hospital readmissions: REMAIN HOME study [Evaluating a model of GP and pharmacist collaboration in primary care in reducing unplanned, all‐cause hospital readmissions: REMAIN HOME study]. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12616001627448 (date of registration 24 November 2016).
ACTRN12617001143314 {unpublished data only}
    1. ACTRN12617001143314. A physician‐led l(L)ifestyle i(I)nterv(V)entional program with goals of weight loss and e(E)xercise participation in overweight and obese patients with heart failure and reduced (REDUCED) ejection fraction. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12617001143314 (date of registration 4 August 2017).
Adair 2012 {published data only}
    1. Adair R, Christianson J, Wholey DR, White KM, Britt HR, Lee SR. Care guides: using trained laypersons to improve chronic disease care. A randomized controlled trial. Journal of General Internal Medicine 2012;27:S137‐.
Agvall 2013 {published data only}
    1. Agvall B, Alehagen U, Dahlstrom U. The benefits of using a heart failure management programme in Swedish primary healthcare. European Journal of Heart Failure 2013;15:228‐36. - PubMed
    1. Agvall B, Paulsson T, Foldevi M, Dahlstrom U, Alehagen U. Resource use and cost implications of implementing a heart failure program for patients with systolic heart failure in Swedish primary health care. International Journal of Cardiology 2014;176(3):731‐8. - PubMed
Aiken 2006 {published data only}
    1. Aiken LS, Butner J, Lockhart CA, Volk‐Craft BE, Hamilton G, Williams FG. Outcome evaluation of a randomized trial of the PhoenixCare intervention: program of case management and coordinated care for the seriously chronically ill. Journal of Palliative Medicine 2006;9(1):111‐26. - PubMed
Akosah 2002 {published data only}
    1. Akosah KO, Schaper AM, Havlik P, Barnhart S, Devine S. Improving care for patients with chronic heart failure in the community: the importance of a disease management program. Chest 2002;122:906‐12. - PubMed
Akosah 2004 {published data only}
    1. Akosah KO, Carothers S. Short‐term aggressive disease management programs for heart failure: effect on drug utilization, clinical outcomes, and costs. Disease Management & Health Outcomes 2004;12(4):221‐7.
Al‐Mobammad 2015 {published data only}
    1. Al‐Mobammad A. Heart failure beyond 50 years of age. GM: Midlife & Beyond 2015;45:21‐4.
Andryukhin 2010 {published data only}
    1. Andryukhin A, Frolova E, Vaes B, Degryse J. The impact of a nurse‐led care programme on events and physical and psychosocial parameters in patients with heart failure with preserved ejection fraction: a randomized clinical trial in primary care in Russia. European Journal of General Practice 2010;16:205‐14. - PubMed
Angermann 2012 {published and unpublished data}
    1. Angermann CE, Stork S, Gelbrich G, Faller H, Jahns R, Frantz S, et al. Mode of action and effects of standardized collaborative disease management on mortality and morbidity in patients with systolic heart failure. Circulation Heart Failure 2012;5:25‐35. - PubMed
    1. ISRCTN23325295. Disease manifestation and disease management in chronic heart failure [A standardised multidisciplinary disease management programme improves mortality and morbidity in patients with systolic heart failure ‐ the Interdisciplinary Network for Heart failure (INH) Study]. apps.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN23325295 (date of registration 30 November 2005).
    1. Neumann A, Mostardt S, Biermann J, Gelbrich G, Goehler A, Geisler PB, et al. Cost‐effectiveness and cost‐utility of a structured collaborative disease management in the Interdisciplinary Network for Heart Failure (INH) study. Clinical Research in Cardiology 2015;104:304‐9. - PubMed
Anonymous 2016 {published data only}
    1. Anonymous. Erratum: Effects of a supportive educational nursing care programme on fatigue and quality of life in patients with heart failure: A randomised controlled trial (European Journal of Cardiovascular Nursing (2016) 15 (157‐167). European Journal of Cardiovascular Nursing 2016;15(5):380. - PubMed
Artinian 2003 {published data only}
    1. Artinian NT, Harden JK, Kronenberg MW, Vander Wal JS, Daher E, Stephens Q, et al. Pilot study of a web‐based compliance monitoring device for patients with congestive heart failure. Heart & Lung: Journal of Acute & Critical Care 2003;32(4):226‐33. - PubMed
Ashton 2014 {published data only}
    1. Ashton K, Oermann MH. Patient education in home care. Home Healthcare Nurse 2014;32(5):288‐94. - PubMed
Austin 2007 {published data only}
    1. Austin J, Williams R, Ross L, Moseley L, Hutchison S. Randomised controlled trial of cardiac rehabilitation in elderly patients with heart failure. European Journal of Heart Failure 2005;7(3 SPEC ISS):411‐7. - PubMed
Azad 2008 {published data only}
    1. Azad N, Molnar F, Byszewski A. Lessons learned from a multidisciplinary heart failure clinic for older women: a randomised controlled trial. Age & Ageing 2008;37(3):282‐7. - PubMed
Azevedo 2002 {published data only}
    1. Azevedo A, Pimenta J, Dias P, Bettencourt P, Ferreira A, Cerqueira‐Gomes M. Effect of a heart failure clinic on survival and hospital readmission in patients discharged from acute hospital care. European Journal of Heart Failure 2002;4:353‐9. - PubMed
Balaban 2017 {published data only}
    1. Balaban RB, Zhang F, Vialle‐Valentin CE, Galbraith AA, Burns ME, Larochelle MR, et al. Impact of a patient navigator program on hospital‐based and outpatient utilization over 180 days in a safety‐net health system. Journal of General Internal Medicine 2017;32(9):981‐9. - PMC - PubMed
Baptiste 2016 {published data only}
    1. Baptiste DL, Davidson P, Groff PL, Becker K, Magloire T, Taylor LA. Feasibility study of a nurse‐led heart failure education program. Contemporary Nurse: A Journal for the Australian Nursing Profession 2016;52(4):499‐510. - PubMed
Barth 2001 {published data only}
    1. Barth V. A nurse‐managed discharge program for congestive heart failure patients: outcomes and costs. Home Health Care Management & Practice 2001;13:436‐43.
Basoor 2011 {published data only}
    1. Basoor A, Doshi N, Cotant J, Todorov M, Saleh T, Patel K, et al. Result of quality improvement discharge tool in congestive heart failure‐randomized controlled trial. Chest 2011;140(4):no pagination.
Bekelman 2014 {published data only}
    1. Bekelman DB, Hooker S, Nowels CT, Main DS, Meek P, McBryde C, et al. Feasibility and acceptability of a collaborative care intervention to improve symptoms and quality of life in chronic heart failure: mixed methods pilot trial. Journal of Palliative Medicine 2014;17(2):145‐51. - PMC - PubMed
Bekelman 2018 {published and unpublished data}
    1. Bekelman D, Allen L, Hattler B, Havranek E P, Fairclough D, McBryde C F, Meek P. Collaborative care to alleviate symptoms and adjust to illness (CASA): primary efficacy results from the casa randomized clinical trial of a palliative symptom and psychosocial care intervention in heart failure. Journal of General Internal Medicine 2017;2(Suppl 1):S141‐2.
    1. Bekelman DB, Allen LA, McBryde CF, Hattler B, Fairclough DL, Havranek EP, et al. Effect of a collaborative care intervention vs usual care on health status of patients with chronic heart failure: the CASA randomized clinical trial. JAMA Internal Medicine 2018;178(4):511‐9. - PMC - PubMed
    1. Bekelman DB, Allen LA, Peterson J, Hattler B, Havranek EP, Fairclough DL, et al. Rationale and study design of a patient‐centered intervention to improve health status in chronic heart failure: the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) randomized trial. Contemporary Clinical Trials 2016;51:1‐7. - PMC - PubMed
    1. NCT01739686. Collaborative care to alleviate symptoms and adjust to illness in chronic heart failure (CASA) trial. clinicaltrials.gov/ct2/show/NCT01739686 (first posted 3 December 2012).
Bell 2016 {published data only}
    1. Bell SP, Schnipper JL, Goggins K, Bian A, Shintani A, Roumie CL, et al. Effect of pharmacist counseling intervention on health care utilization following hospital discharge: a randomized control trial. Journal of General Internal Medicine 2016;31(5):470‐7. - PMC - PubMed
Benatar 2003 {published data only}
    1. Benatar D, Bondmass M, Ghitelman J, Avitall B. Outcomes of chronic heart failure. Archives of Internal Medicine 2003;163(3):347‐52. [15534] - PubMed
Blaha 2000 {published data only}
    1. Blaha C, Robinson JM, Pugh LC, Bryan Y, Havens DS. Longitudinal nursing case management for elderly heart failure patients: notes from the field. Nursing Case Management : Managing the Process of Patient Care 2000;5(1):32‐6. - PubMed
Bocchi 2004 {published data only}
    1. Alcides E Bocchi. Heart failure clinics: The Brazilian experience. Revista Portuguesa de Cardiologia 2004;23(SUPPL 3):III47‐55. - PubMed
Bocchi 2008 {published and unpublished data}
    1. Bocchi EA, Cruz F, Guimaraes G, Pinho Moreira LF, Issa VS, Ayub Ferreira SM, et al. Long‐term prospective, randomized, controlled study using repetitive education at six‐month intervals and monitoring for adherence in heart failure outpatients: the REMADHE trial. Circulation. Heart Failure 2008;1:115‐24. - PubMed
    1. NCT00505050. A long‐term prospective randomized controlled study using repetitive education at six‐month intervals and monitoring for adherence in heart failure outpatients ‐ the REMADHE study (REMADHE). clinicaltrials.gov/ct2/show/NCT00505050 (first posted 20 July 2007).
Bondmass 2007 {published data only}
    1. Bondmass MD. Improving outcomes for African Americans with chronic heart failure: a comparison of two home care management delivery methods. Home Health Care Management & Practice 2007;20(1):8‐21.
Boutwell 2014 {published data only}
    1. Boutwell AE, Sullivan W, Nystrom K, Nolan L, Gassett RS, Ryan J. Two home health agencies reduce readmissions among heart failure patients using a quality improvement approach. Journal of Clinical Outcomes Management 2014;21(7):309‐12.
Bouvy 2003 {published data only}
    1. Bouvy ML, Heerdink ER, Urquhart J, Grobbee DE, Hoe AW, Leufkens HGM. Effect of a pharmacist‐led intervention on diuretic compliance in heart failure patients: a randomized controlled study. Journal of Cardiac Failure 2003;9(5):404‐11. - PubMed
Brannstrom 2013 {published data only}
    1. Brannstrom M, Boman K. A new model for integrated heart failure and palliative advanced homecare‐‐rationale and design of a prospective randomized study. European Journal of Cardiovascular Nursing 2013;12:269‐75. - PubMed
Brannstrom 2014 {published data only}
    1. Brannstrom M, Boman K. Effects of person‐centred and integrated chronic heart failure and palliative home care. PREFER: a randomized controlled study. European Journal of Heart Failure 2014;16(10):1142‐51. - PubMed
Bucci 2003 {published data only}
    1. Bucci C, Jackevicius C, McFarlene K, Liu P. Pharmacist's contribution in a heart function clinic: patient perception and medication appropriateness. Canadian Journal of Cardiology 2003;19(4):391‐6. - PubMed
Byrnes 2012 {published data only}
    1. Byrnes JM, Goldstein S, Venator B, Pollicino C, Ng SK, Veroff D, et al. The impact of population‐based disease management services for selected chronic conditions: the Costs to Australian Private Insurance‐‐Coaching Health (CAPICHe) study protocol. BMC Public Health 2012;12:114. - PMC - PubMed
Capomolla 2004 {published data only}
    1. Capomolla S, Pinna GD, Rovere MT, Maestri R, Ceresa M, Ferrari M, et al. Heart failure case disease management program: a pilot study of home telemonitoring versus usual care. European Heart Journal Supplements 2004;6(6):F91–8.
Chen 2017 {published data only}
    1. Chen M, Xue L, Cha C, Liang J, Ma P. Impact of strengthening clinical management and intervention on prognosis and compliance among patients with heart failure. Biomedical Research (India) 2017;28(13):5751‐7.
Cleland 2005 {published data only}
    1. Cleland JG, Louis AA, Rigby AS, Janssens U, Balk AH. Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death: the Trans‐European Network‐Home‐Care Management System (TEN‐HMS) study. Journal of the American College of Cardiology 2005;45(10):1654‐64. - PubMed
Comin‐Colet 2016 {published data only}
    1. Comin‐Colet J, Enjuanes C, Verdu‐Rotellar JM, Linas A, Ruiz‐Rodriguez P, Gonzalez‐Robledo G, et al. Impact on clinical events and healthcare costs of adding telemedicine to multidisciplinary disease management programmes for heart failure: results of a randomized controlled trial. Journal of Telemedicine and Telecare 2016;22(5):282‐95. - PubMed
Cordisco 1999 {published data only}
    1. Cordisco ME, Benjaminovitz A, Hammond K, Mancini D. Use of telemonitoring to decrease the rate of hospitalization in patients with severe congestive heart failure. American Journal of Cardiology 1999;84:860‐2. - PubMed
Costantini 2001 {published data only}
    1. Costantini O, Huck K, Carlson MD, Boyd K, Buchter CM, Raiz P. Impact of a guideline‐based disease management team on outcomes of hospitalized patients with congestive heart failure. Archives of Internal Medicine 2001;161:177‐82. [5712] - PubMed
Deek 2016 {published data only}
    1. Deek H, Newton PJ, Noureddine S, Inglis SC, Al Arab G, Kabbani S, et al. Protocol for a block randomised controlled trial of an intervention to improve heart failure care. Nurse Research 2016;23(4):24‐9. - PubMed
Deek 2017 {published data only}
    1. Deek H, Chang S, Newton PJ, Noureddine S, Inglis SC, Arab G, et al. An evaluation of involving family caregivers in the self‐care of heart failure patients on hospital readmission: randomised controlled trial (the FAMILY study). International Journal of Nursing Studies 2017;75:101‐11. - PubMed
Delaney 2013 {published data only}
    1. Delaney C, Apostolidis B, Bartos S, Morrison H, Smith L, Fortinsky R. A randomized trial of telemonitoring and self‐care education in heart failure patients following home care discharge. Home Health Care Management & Practice 2013;25:187‐95.
de la Porte 2007 {published data only}
    1. Porte PW, Lok DJ, Veldhuisen DJ, Wijngaarden J, Cornel JH, Zuithoff NP, et al. Added value of a physician‐and‐nurse‐directed heart failure clinic: results from the Deventer‐Alkmaar heart failure study. Heart 2007;93(7):819‐25. - PMC - PubMed
de Lusignan 1999 {published data only}
    1. Lusignan S, Meredith K, Wells S, Leatham E, Johnson P. A controlled pilot study in the use of telemedicine in the community on the management of heart failure‐a report of the first three months. Studies in Health Technology & Informatics 1999;64:126‐37. - PubMed
Dewalt 2006 {published data only}
    1. Dewalt DA, Malone RM, Bryant ME, Kosnar MC, Corr KE, Rothman RL, et al. A heart failure self‐management program for patients of all literacy levels: a randomized, controlled trial [ISRCTN11535170]. BMC Health Services Research 2006;6:30. - PMC - PubMed
DeWalt 2012 {published data only}
    1. DeWalt DA, Schillinger D, Ruo B, Bibbins‐Domingo K, Baker DW, Holmes GM, et al. Multisite randomized trial of a single‐session versus multisession literacy‐sensitive self‐care intervention for patients with heart failure. Circulation 2012;125:2854‐62. - PMC - PubMed
Dickson 2015 {published data only}
    1. Dickson VV, Melkus GD, Dorsen C, Katz S, Riegel B. Improving heart failure self‐care through a community‐based skill‐building intervention: a study protocol. Journal of Cardiovascular Nursing 2015;30(4 Suppl 1):S14‐24. - PubMed
Discher 2003 {published data only}
    1. Discher CL, Klein D, Pierce L, Levine AB, Levine TB. Heart failure disease management: impact on hospital care, length of stay, and reimbursement. Congestive Heart Failure 2003;9(2):77‐83. - PubMed
Dracup 2012 {published data only}
    1. Dracup K, Moser DK, Pelter MM, Nesbitt T, Southard J, Robinson S, et al. Improving self care behavior and clinical outcomes in rural patients with heart failure. Journal of Cardiac Failure 2012;18(11):882‐3.
Dracup 2014 {published and unpublished data}
    1. Dracup K, Moser D, Pelter M, Nesbitt T, Southard J, Paul SM, et al. A focused heart failure self‐care intervention reduces cardiac deaths in rural patients. Circulation 2012;1.
    1. Dracup K, Moser DK, Pelter MM, Nesbitt TS, Southard J, Paul SM, et al. Randomized, controlled trial to improve self‐care in patients with heart failure living in rural areas. Circulation 2014;130(3):256‐64. - PubMed
    1. NCT00415545. Educational program to improve heart failure outcomes in adults living in rural areas (REMOTE‐HF). clinicaltrials.gov/ct2/show/NCT00415545 (first posted 25 December 2006).
Duffy 2005 {published data only}
    1. Duffy JR, Hoskins LM, Dudley‐Brown S. Development and testing of a caring‐based intervention for older adults with heart failure. Journal of Cardiovascular Nursing 2005;20(5):325‐33. - PubMed
Ekman 1998 {published data only}
    1. Ekman I, Andersson B, Ehnfors M, Matejka G, Persson B, Fagerberg B. Feasibility of a nurse‐monitored, outpatient‐care programme for elderly patients with moderate‐to‐severe, chronic heart failure. European Heart Journal 1998;19:1254‐60. - PubMed
    1. Ekman I, Andersson B, Ehnfors M, Matejka G, Persson B, Fagerberg B. Outpatient care programmes for the elderly [letter]. European Heart Journal 1999;20:393‐4. - PubMed
ElGuindy 2013 {published data only}
    1. ElGuindy AM, ElMaghawry M. BLOCK‐HF: CRT gains new ground. Global Cardiology Science and Practice 2013;43:1‐3. - PMC - PubMed
Evans 1993 {published data only}
    1. Evans RL, Hendricks RD. Evaluating hospital discharge planning: a randomized clinical trial. Medical Care 1993;31:358‐70. - PubMed
Fabbri 2007 {published data only}
    1. Fabbri G, Gorini M, Maggioni AP, Oliva F, Area Scompenso ANMC. Heart failure: the importance of a disease management program. Giornale Italiano di Cardiologia 2007;8(6):353‐8. - PubMed
Farag 1967 {published data only}
    1. Farag SA, Mozar HN. Preventing recurrences of congestive heart failure. Journal of The American Dietetic Association 1967;51:26‐8. - PubMed
Feldman 2004 {published data only}
    1. Feldman PH, Peng TR, Murtaugh CM, Kelleher C, Donelson SM, McCann ME, et al. A randomized intervention to improve heart failure outcomes in community‐based home health care. Home Health Care Services Quarterly 2004;23(1):1‐23. - PubMed
Fermann 2017 {published data only}
    1. Fermann GJ, Levy PD, Pang P, Butler J, Ayaz SI, Char D, et al. Design and rationale of a randomized trial of a care transition strategy in patients with acute heart failure discharged from the emergency department: GUIDED‐HF (Get With the Guidelines in Emergency Department Patients With Heart Failure). Circulation 2017;10(2):e003581. - PMC - PubMed
Fitzgerald 1994 {published data only}
    1. Fitzgerald JF, Smith DM, Martin DK, Freedman JA, Katz BP. A case manager intervention to reduce readmissions. Archives of Internal Medicine 1994;154:1721‐9. - PubMed
Flynn 2005 {published data only}
    1. Flynn KJ, Powell LH, Mendes de Leon CF, Munoz R, Eaton CB, Downs DL, et al. Increasing self‐management skills in heart failure patients: a pilot study. Congestive Heart Failure 2005;11(6):297‐302. - PubMed
Foley 2008 {published data only}
    1. Foley S. In the news. Heart failure study: nurse‐led management proves disheartening. American Journal of Nursing 2008;108(5):19‐20.
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Galbreath 2004 {published data only}
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    1. Goldberg LR, Piette JD, Walsh MN, Frank TA, Jaski BE, Smith AL, et al. Randomized trial of a daily electronic home monitoring system in patients with advanced heart failure: The Weight Monitoring in Heart Failure (WHARF) trial. American Heart Journal 2003;146:705‐12. - PubMed
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ISRCTN18285541 {unpublished data only}
    1. ISRCTN18285541. Effect of a dual intervention in elderly heart failure patients with cognitive impairment and their caregivers after hospital discharge: a randomized controlled trial [Effect of a disease management program in elderly heart failure patients with cognitive impairment after a hospital discharge, through a dual intervention in patients and caregivers and its follow‐up by a multidisciplinary team, delivered by geriatric day‐hospital vs. usual care]. apps.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN18285541 (date of registration 1 March 2016).
ISRCTN71548370 {unpublished data only}
    1. ISRCTN71548370. Motivational nursing intervention on treatment adherence in heart failure patients [The effectiveness of a motivational nursing intervention based on the stages of change on treatment adherence in heart failure patients]. www.isrctn.com/ISRCTN71548370 (date assigned 23 December 2008).
Jaarsma 2003 {published data only}
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Kalter‐Leibovici 2017 {published data only}
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    1. JPRN‐UMIN000001715. A randomized controlled trial investigating the effectiveness of self‐management program for patients with heart failure. upload.umin.ac.jp/cgi‐open‐bin/ctr_e/ctr_view.cgi?recptno=R000002067 (date of disclosure 18 February 2009).
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    1. Liljeroos M, Agren S, Jaarsma T, Arestedt K, Stromberg A. Long‐term effects of a dyadic psycho‐educational intervention on caregiver burden and morbidity in partners of patients with heart failure: a randomized controlled trial. Quality of Life Research 2017;26(2):367‐79. - PubMed
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NCT00300261 {unpublished data only}
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NCT01014884 {unpublished data only}
    1. NCT01014884. Coventry Outcomes Study of Seniors (COSS): a comparative effectiveness study to evaluate the effect of a multidisciplinary team's intervention on the incidence of nonelective hospitalizations in a Medicare population (COSS). clinicaltrials.gov/ct2/show/NCT01014884 (first posted 17 November 2009).
NCT01141907 {unpublished data only}
    1. NCT01141907. Nurse‐led heart failure care transition intervention for African Americans: the Navigator Program. clinicaltrials.gov/ct2/show/NCT01141907 (first posted 11 June 2010).
NCT01342276 {published and unpublished data}
    1. NCT01342276. Trial of an internet‐based platform for monitoring heart failure patients (vHFC). clinicaltrials.gov/ct2/show/NCT01342276 (first posted 27 April 2011).
NCT01698242 {unpublished data only}
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NCT01820780 {unpublished data only}
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NCT01878630 {unpublished data only}
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NCT01886534 {unpublished data only}
    1. NCT01886534. Caregiver enhanced assistance and support for the elderly heart failure patient at hospital discharge (CEASE‐HF). clinicaltrials.gov/ct2/show/NCT01886534 (first posted 26 June 2013).
NCT02110433 {unpublished data only}
    1. NCT02110433. Heart failure educational and follow up platform (HELP). clinicaltrials.gov/ct2/show/NCT02110433 (first posted 10 April 2014).
NCT02425488 {unpublished data only}
    1. NCT02425488. Nursing therapeutics education and heart failure (HF): a study protocol (NEHF). clinicaltrials.gov/ct2/show/NCT02425488 (first posted 24 April 2015).
NCT03035474 {unpublished data only}
    1. NCT03035474. Care optimization through patient and hospital engagement clinical trial for heart failure (CONNECT‐HF). clinicaltrials.gov/ct2/show/NCT03035474 (first posted 30 January 2017).
NCT03220204 {unpublished data only}
    1. NCT03220204. Researching emotions and cardiac health: phase III (REACH III). clinicaltrials.gov/ct2/show/NCT03220204 (first posted 18 July 2017).
NCT03246035 {unpublished data only}
    1. NCT03246035. Reducing readmission for frail elderly patients with decompensated heart failure (HFF‐ED). clinicaltrials.gov/ct2/show/NCT03246035 (first posted 11 August 2017).
NCT03317951 {unpublished data only}
    1. NCT03317951. Investigation of a novel integrated care concept (NICC) for patients suffering from chronic cardiovascular disease (CardioCare MV). clinicaltrials.gov/ct2/show/NCT03317951 (first posted 23 October 2017).
Nguyen 2007 {published data only}
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    1. NCT01076465. Efficacy of a disease management program in very old patients with heart failure. clinicaltrials.gov/ct2/show/NCT01076465 (first posted 26 February 2010).
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    1. NCT00018005. A self‐management intervention for mild to moderate heart failure (HART). clinicaltrials.gov/ct2/show/NCT00018005 (first posted 26 June 2001).
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Rao 2007 {published data only}
    1. ISRCTN16302432. Impact of specialist care in patients with newly diagnosed heart failure: a randomised controlled study. apps.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN16302432 (date of registration 7 September 2005).
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RBR‐9c3ssc {unpublished data only}
    1. RBR‐9c3ssc. Effect of telephone consultation associated with short messaging service (SMS) in patients with heart failure. apps.who.int/trialsearch/Trial2.aspx?TrialID=RBR‐9c3ssc (date of registration 9 March 2018).
Reed 2017 {published data only}
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Reeder 2014 {published data only}
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Rich 1993 {published data only}
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Rich 1995 {published data only}
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Riegel 2000 {published data only}
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Riegel 2002 {published data only}
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Rodriguez‐Gazquez 2012 {published data only}
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Rondinini 2008 {published data only}
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Rosen 2017 {published data only}
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Rubens 2014 {published data only}
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Santos 2014 {published data only}
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Scalvini 2016 {published data only}
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Serxner 1998 {published data only}
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Sezgin 2017 {published data only}
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    1. NCT00012870. Effect of behavioral management on quality of life in heart failure. clinicaltrials.gov/ct2/show/record/NCT00012870 (first posted March 16, 2001).
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Sisk 2006 {published and unpublished data}
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Smeulders 2006 {published data only}
    1. NTR467. Self‐management and congestive heart failure: a randomized controlled trial to improve health‐behavior and health‐related quality of life by increasing self‐efficacy expectancies in congestive heart failure patients.. apps.who.int/trialsearch/Trial2.aspx?TrialID=NTR467 (date of retrospective registration: 21 October 2005).
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Smeulders 2010 {published data only}
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Smith 2005 {published data only}
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Smith 2014 {published data only}
    1. Smith CE, Piamjariyakul U, Dalton KM, Russell C, Wick J, Ellerbeck EF. Nurse‐led multidisciplinary heart failure group clinic appointments: methods, materials, and outcomes used in the clinical trial. Journal of Cardiovascular Nursing 2015;30(4 Suppl 1):S25‐34. - PMC - PubMed
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Srisuk 2017 {published data only}
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Stamp 2016 {published data only}
    1. Stamp KD, Dunbar SB, Clark PC, Reilly CM, Gary RA, Higgins M, et al. Family partner intervention influences self‐care confidence and treatment self‐regulation in patients with heart failure. European Journal of Cardiovascular Nursing 2016;15(5):317‐27. - PMC - PubMed
Stewart 1998a {published data only}
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Stewart 1998b {published data only}
    1. Stewart S, Pearson S, Horowitz JD. Effects of a home‐based intervention among patients with congestive heart failure discharged from acute hospital care. Archives of Internal Medicine 1998;158:1067‐72. - PubMed
Stewart 1999b {published data only}
    1. Stewart S, Vandenbroek AJ, Pearson S, Horowitz JD. Prolonged beneficial effects of a home‐based intervention on unplanned re‐admissions and mortality among patients with congestive heart failure. Archives of Internal Medicine 1999;159:257‐61. - PubMed
Stewart 2002 {published data only}
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Stewart 2012 {published data only}
    1. Maru S, Byrnes J, Carrington MJ, Chan YK, Thompson DR, Stewart S, et al. Cost‐effectiveness of home versus clinic‐based management of chronic heart failure: extended follow‐up of a pragmatic, multicentre randomized trial cohort ‐ The WHICH? study (Which Heart Failure Intervention Is Most Cost‐Effective & Consumer Friendly in Reducing Hospital Care). International Journal of Cardiology 2015;201:368‐75. - PubMed
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    1. Stewart S, Carrington M, Chan YK. Projected benefits of a home‐based approach to chronic heart failure management: long‐term data from the multicentre Which Intervention is most Cost‐effective and consumer friendly in reducing Hospital stay trial. Global Heart 2014;9(1 SUPPL. 1):e51.
    1. Stewart S, Carrington MJ, Marwick TH, Davidson PM, Macdonald P, Horowitz JD, et al. Impact of home versus clinic‐based management of chronic heart failure: the WHICH? (Which Heart Failure Intervention Is Most Cost‐Effective & Consumer Friendly in Reducing Hospital Care) multicenter, randomized trial. Journal of the American College of Cardiology 2012;60:1239‐48. - PubMed
Stewart 2014 {published data only}
    1. Stewart S, Carrington MJ, Horowitz JD, Marwick TH, Newton PJ, Davidson PM, et al. Prolonged impact of home versus clinic‐based management of chronic heart failure: extended follow‐up of a pragmatic, multicentre randomized trial cohort. International Journal of Cardiology 2014;174(3):600‐10. - PubMed
TEC4 2016 {published data only}
    1. TEC4Home Healthcare Innovation Community. Supporting heart failure patient transitions from acute to community care with home telemonitoring technology: a protocol for a provincial randomized controlled trial (TEC4Home). Journal of Medical Internet Research 2016;18(12):1. - PMC - PubMed
Thompson 2014 {published data only}
    1. Thompson C. Safe passage: a nurse‐led multidisciplinary team approach to improving transitions and reducing readmissions for heart failure patients. Heart & Lung 2014;43(4):386.
Tibaldi 2009 {published data only}
    1. Tibaldi V, Isaia G, Scarafiotti C, Gariglio F, Zanocchi M, Bo M, et al. Hospital at home for elderly patients with acute decompensation of chronic heart failure: a prospective randomized controlled trial. Archives of Internal Medicine 2009;169:1569‐75. - PubMed
Topp 1998 {published data only}
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Townsend 1988 {published data only}
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Trochu 2003 {published data only}
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Umeda 2014 {published data only}
    1. Umeda A, Inoue T, Takahashi T, Wakamatsu H. Telemonitoring of patients with implantable cardiac devices to manage heart failure: an evaluation of tablet‐PC‐based nursing intervention program. Open Journal of Nursing 2014;4(4):237‐50.
Vaillant‐Roussel 2014 {published data only}
    1. Vaillant‐Roussel H, Laporte C, Pereira B, Cassagnes J, Ruivard M, Clément G, et al. Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial. BMC Family Practice 2014;15(1):321‐40. - PMC - PubMed
Valle 2004 {published data only}
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Van der Kluit 2014 {published data only}
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Van Lieshout 2011 {published data only}
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Van Rossum 1993 {published data only}
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Villanueva 2015 {published data only}
    1. Villanueva NA, Rivas AH, Diaz MN, Rodriguez MM, Gomez TS, Lopez VG. Improve of the treatment adherence, of the quality of life and the morbidity of the heart failure patients. European Journal of Heart Failure 2015;17:424.
Vorilhon 2016 {published data only}
    1. Vorilhon C, Jean F, Mulliez A, Clerfond G, Pereira B, Sapin V, et al. Optimized management of heart failure patients aged 80 years or more improves outcomes versus usual care: the HF80 randomized trial. Archives of Cardiovascular Diseases 2016;109(12):667‐78. - PubMed
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Wagenaar 2015 {published data only}
    1. Wagenaar KP, Broekhuizen BD, Dickstein K, Jaarsma T, Hoes AW, Rutten FH. Effectiveness of an interactive platform, and the ESC/HFA heartfailurematters.org website in patients with heart failure: design of the multicentre randomized e‐Vita heart failure trial. European Journal of Heart Failure 2015;17(12):1310‐6. - PubMed
Warber 2011 {published data only}
    1. Warber SL, Ingerman S, Moura VL, Wunder J, Northrop A, Gillespie BW, et al. Healing the heart: a randomized pilot study of a spiritual retreat for depression in acute coronary syndrome patients. Explore: The Journal of Science and Healing 2011;7:222‐33. - PubMed
Weinberger 1996 {published data only}
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Welsh 2013 {published data only}
    1. Welsh D, Lennie TA, Marcinek R, Biddle MJ, Abshire D, Bentley B, et al. Low‐sodium diet self‐management intervention in heart failure: pilot study results. European Journal of Cardiovascular Nursing 2013;12:87‐95. - PMC - PubMed
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Wongpiriyayothar 2008 {published data only}
    1. Wongpiriyayothar A, Pothiban L, Liehr P, Senaratana W, Sucumvang K. Effects of home‐based care program on symptom alleviation and well‐being among persons with chronic heart failure. Thai Journal of Nursing Research 2008;12(1):25‐40.
Woodend 2008 {published data only}
    1. Woodend KA, Sherrard H, Fraser M, Stuewe L, Tim Cheung T, Struthers C. Telehome monitoring in patients with cardiac disease who are at high risk of readmission. Heart & Lung 2008;37(1):36‐45. - PubMed
Yallop 2006 {published data only}
    1. Yallop J, Chan B, Piterman P, Tonkin A, Forbes A, Davidson PM, et al. The Chronic Heart‐failure Assistance by Telephone (CHAT) study: a new model of care to support aging rural patients with chronic disease. Asian Pacific Family Medicine 2006;5:2.
Yeshchenko 2014 {published data only}
    1. Yeshchenko Y. Impact of individual self‐control and self‐care skills training programs and group learning on treatment adherence in patients with heart failure. European Journal of Heart Failure 2014;16:122.
Young 2016 {published data only}
    1. NCT01964053. Self‐management adherence in heart failure patients (PATCH). clinicaltrials.gov/ct2/show/NCT01964053 (first posted 17 October 2013).
    1. Young L, Barnason S, Do V. Promoting self‐management through adherence among heart failure patients discharged from rural hospitals: a study protocol. F1000Research 2014;3:317. - PMC - PubMed
    1. Young L, Hertzog M, Barnason S. Effects of a home‐based activation intervention on self‐management adherence and readmission in rural heart failure patients: the PATCH randomized controlled trial. BMC Cardiovascular Disorders 2016;16(1):176. - PMC - PubMed
Yu 2015b {published data only}
    1. Yu M, Chair SY, Chan CW, Choi KC. A health education booklet and telephone follow‐ups can improve medication adherence, health‐related quality of life, and psychological status of patients with heart failure. Heart & Lung 2015;44(5):400‐7. - PubMed

References to studies awaiting assessment

Anguita 2005 {published data only}
    1. Anguita SM, Ojeda S, Atienza F, Ridocci F, Almenar L, Valles F, et al. A cost‐benefit analysis of disease management programs for preventing rehospitalizations in patients with heart failure. Economic impact of new organizative forms of heart failure management. Revista Espanola de Cardiologia 2005;58(SUPPL 2):32‐6.
Begrambekova 2013 {published data only}
    1. Begrambekova J, Mareev VU, Danielan M. National heart failure registry: effect of the patient observation, monitoring and education on clinical and economical outcomes. European Journal of Heart Failure. 2013; Vol. 12:S227.
Begrambekova 2016 {published data only}
    1. Begrambekova JL, Drobizhev MY, Mareev VY. Effect of successful treatment and non‐pharmacological disease management program on severity of anxiety and depression symptoms in congestive heart failure patients. European Journal of Heart Failure 2016;18:95.
    1. Begrambekova YL, Mareev VY. Role of depression in effectiveness of disease management programs. European Journal of Heart Failure 2015;17:204‐5.
    1. Mareev V, Danielyan M, Yu B. Congestive heart failure: a multidisciplinary non‐pharmacological approach for changing in re‐hospitalisation and prognosis in patients with concomitant anxiety and depression (CHANCE‐AND). Journal of Cardiac Failure 2010;16(11):913.
Chung 2014 {published data only}
    1. Chung ML, Lennie TA, Moser DK. The feasibility of the family cognitive educational intervention to improve depressive symptoms and quality of life in patients with heart failure and their family caregivers. Journal of Cardiac Failure 2014;20(8 SUPPL 1):S52.
Fan 2010 {published data only}
    1. Fan HH, Shi HY, Jin W, Zhu YJ, Huang DN, Yan YW, et al. Effects of integrated disease management program on the outcome of patients with heart failure CNO ‐ CN‐01087011. Chung Hua Hsin Hsueh Kuan Ping Tsa Chih 2010;38(7):592‐6. - PubMed
ISRCTN13668364 {unpublished data only}
    1. ISRCTN13668364. A general practice nurse intervention for heart failure (HF) patients. apps.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN13668364 (date of registration 12 September 2003).
Mizukawa 2014 {published data only}
    1. Mizukawa M, Moriyama M, Naka M, Tomiyama M, Kobayashi S, Kitagawa T, et al. Telemonitoring in patients with chronic heart failure: multicenter randomized trial in Japan (pilot study). Journal of Cardiac Failure 2014;20(10 SUPPL. 1):S144.
NCT00166049 {unpublished data only}
    1. NCT00166049. Education and supportive partners improving self‐care (ENSPIRE). clinicaltrials.gov/ct2/show/NCT00166049 (first posted 14 September 2005).
NCT00182182 {unpublished data only}
    1. NCT00182182. Evaluation of a primary care based heart failure management program. clinicaltrials.gov/ct2/show/NCT00182182 (first posted 16 September 2005).
NCT01378247 {unpublished data only}
    1. NCT01378247. Multicenter study of family nursing to treat heart failure. clinicaltrials.gov/ct2/show/NCT01378247 (first posted 22 June 2011).
NCT01461681 {unpublished data only}
    1. NCT01461681. Improving care of patients with heart failure. clinicaltrials.gov/ct2/show/NCT01461681 (first posted 28 October 2011).
NCT02112227 PACT‐HF {unpublished data only}
    1. NCT02112227. Patient‐centered care transitions in heart failure: a pragmatic cluster randomized trial (PACT‐HF). clinicaltrials.gov/ct2/show/NCT02112227 (first posted 11 April 2014).
NCT02251899 {published data only}
    1. NCT02251899. A disease management study targeted to reduce health care utilization for patients with congestive heart failure. clinicaltrials.gov/ct2/show/NCT02251899 (first posted 29 September 2014).
NCT02331524 {unpublished data only}
    1. NCT02331524. Interventions to improve daily activity in heart failure. clinicaltrials.gov/ct2/show/NCT02331524 (first posted 6 January 2015).
Ortiz 2017 {published data only}
    1. Ortiz C, Diaz M, Delgado‐Nicolas MA, Moran‐Fernandez L, Juan‐Baguda J, Ponz I, et al. Evaluation of a nurse‐led cross intervention program in heart failure. European Journal of Heart Failure 2017;19:306‐7.
Shao 2014 {published data only}
    1. Shao J, Chen SH, Chien LY. A self‐management program for older people with heart failure: a randomized trial. Global Heart 2014;9(1 SUPPL 1):e75.

References to ongoing studies

Bendelac 2014 {published data only}
    1. Bendelac H, Pathak A, Molinier L, Ruidavets JB, Mayere A, Berry, et al. Optimization of ambulatory monitoring of patients with heart failure using telecardiology (OSICAT). European Research in Telemedicine 2014;3(4):161‐7.
Ding 2017 {published data only}
    1. Ding H, Jayasena R, Maiorana A, Dowling A, Chen SH, Karunanithi M, et al. Innovative Telemonitoring Enhanced Care Programme for Chronic Heart Failure (ITEC‐CHF) to improve guideline compliance and collaborative care: protocol of a multicentre randomised controlled trial. BMJ Open 2017;7(10):no pagination. - PMC - PubMed
Hardman S {published data only}
    1. The evaluation of a nurse‐led intervention to improve self‐management for patients admitted to hospital with a diagnosis of heart failure (due to left ventricular systolic dysfunction). Ongoing study NA, study likely to be completed in 2005.
Massie 2001 {published data only}
    1. A controlled trial of heart failure management programs. Ongoing study NA.
NCT02044211 {unpublished data only}
    1. NCT02044211. Blended collaborative care for heart failure and co‐morbid depression. clinicaltrials.gov/ct2/show/NCT02044211 (first posted 23 January 2014).
NCT02481921 {unpublished data only}
    1. NCT02481921. Group medical visits in heart failure (MEDIC‐HF). clinicaltrials.gov/ct2/show/NCT02481921 (first posted 25 June 2015).
NCT02894502 {unpublished data only}
    1. NCT02894502. Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF). clinicaltrials.gov/ct2/show/NCT02894502 (first posted 9 September 2016).
NCT03012256 {unpublished data only}
    1. NCT03012256. The DIVERT‐CARE (collaboration action research & evaluation) trial. clinicaltrials.gov/ct2/show/NCT03012256 (first posted 6 January 2017).
NCT03035123 {unpublished data only}
    1. NCT03035123. Therapeutic education strategies for patients with acute heart failure (EduStra‐HF). clinicaltrials.gov/ct2/show/NCT03035123 (first posted 27 January 2017).
NCT03108235 {unpublished data only}
    1. NCT03108235. Home‐based heart failure self‐management programme study (HOM‐HEMP). clinicaltrials.gov/ct2/show/NCT03108235 (first posted 11 April 2017).
NCT03555318 {unpublished data only}
    1. NCT03555318. Intervention by a cardiologist and geriatrician in elderly patients after admission due to heart failure. clinicaltrials.gov/ct2/show/NCT03555318 (first posted 13 June 2018).
Oksman 2017 {published data only}
    1. Oksman E, Linna M, Horhammer I, Lammintakanan J, Talja M. Cost‐effectiveness analysis for a tele‐based health coaching programme for chronic disease in primary care. BMC Health Services Research 2017;17(138):1‐7. [DOI: 10.1186/s12913-017-2088-4] - DOI - PMC - PubMed
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Pugh 1999 {published data only}
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References to other published versions of this review

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