Cochrane · systematic review · CD002752
Disease management interventions for heart failure
Takeda, A, Martin, N, Taylor, RS, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
HeartAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
17
No studies
4
Included studies
NR
No studies 4 · 19%Ungraded 0 · 0%Very low 3 · 14.3%Low 9 · 42.9%Moderate 5 · 23.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Case management compared to usual care for heart failure
Population: adults with heart failure
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
HF mortality Case management vs usual care | no estimate extracted | NR | No studies |
All‐cause mortality Case management vs usual care | RR 0.78 [0.68, 0.9] | 26 studies · 6903 participants | Low Downgraded: risk of bias, publication bias |
HF readmissions Case management vs usual care | RR 0.64 [0.53, 0.78] | 12 studies · 2528 participants | Moderate Downgraded: publication bias |
All‐cause readmissions Case management vs usual care | RR 0.92 [0.83, 1.01] | 14 studies · 4539 participants | Moderate Downgraded: imprecision |
Adverse effects Case management vs usual care | no estimate extracted | NR | No studies |
Quality of life (MLHFQ mean score at end of Case management vs usual care | no estimate extracted | 8 studies · 1595 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Costs and cost‐effectiveness Case management vs usual care | no estimate extracted | 11 studies · 2369 participants | Low Downgraded: inconsistency, indirectness |
Clinic‐based intervention compared to usual care for heart failure
Population: adults with heart failure
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
HF mortality Clinic‐based intervention vs usual care | no estimate extracted | NR | No studies |
All‐cause mortality Clinic‐based intervention vs usual care | RR 0.87 [0.68, 1.1] | 7 studies · 1686 participants | Low Downgraded: risk of bias, imprecision |
HF readmissions Clinic‐based intervention vs usual care | RR 1.01 [0.87, 1.18] | 2 studies · 887 participants | Moderate Downgraded: risk of bias |
All‐cause readmissions Clinic‐based intervention vs usual care | RR 0.9 [0.72, 1.12] | 4 studies · 1129 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects Clinic‐based intervention vs usual care | no estimate extracted | NR | No studies |
Quality of life Clinic‐based intervention vs usual care | no estimate extracted | 4 studies · 641 participants | Low Downgraded: risk of bias, imprecision |
Costs and cost‐effectiveness Clinic‐based intervention vs usual care | no estimate extracted | 2 studies · 390 participants | Low Downgraded: imprecision, indirectness |
Multidisciplinary disease management programmes compared to usual care for heart failure
Population: adults with heart failure
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
HF mortality Multidisciplinary disease management programmes vs usual care | RR 0.46 [0.23, 0.95] | 2 studies · 277 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
All‐cause mortality Multidisciplinary disease management programmes vs usual care | RR 0.67 [0.54, 0.83] | 8 studies · 1764 participants | Moderate Downgraded: risk of bias |
HF readmissions Multidisciplinary disease management programmes vs usual care | RR 0.68 [0.5, 0.92] | 5 studies · 1108 participants | Low Downgraded: risk of bias, inconsistency |
All‐cause readmissions Multidisciplinary disease management programmes vs usual care | RR 0.85 [0.71, 1.01] | 5 studies · 1152 participants | Low Downgraded: risk of bias |
Adverse effects Multidisciplinary disease management programmes vs usual care | no estimate extracted | 2 studies · 496 participants | Moderate Downgraded: imprecision |
Quality of life (MLHFQ) Multidisciplinary disease management programmes vs usual care | no estimate extracted | 2 studies · 140 participants | Very low Downgraded: risk of bias, imprecision |
Costs and cost‐effectiveness Multidisciplinary disease management programmes vs usual care | no estimate extracted | 1 study · 117 participants | Low Downgraded: imprecision, indirectness |