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Strategies to Modify the Risk for Heart Failure Readmission: A Systematic Review and Meta-analysis

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Population Health Management for Poly Chronic Conditions

Abstract

Human factors play an important role in health-care outcomes of heart failure patients. A systematic review and meta-analysis of clinical trial studies on heart failure hospitalization may yield positive proofs of the beneficial effect of specific care management strategies.

We investigate how the eight guiding principles of choice, rest, environment, activity, trust, interpersonal relationships, outlook, and nutrition may reduce heart failure (HF) readmissions.

Appropriate keywords were identified related to the (1) independent variable of hospitalization and treatment, (2) moderating variable of care management principles, (3) dependent variable of readmission, and (4) disease of HF to conduct searches in nine databases on clinical trial studies. In the meta-analysis, data were collected from studies that measured HF readmission for individual patients. The results indicate that an intervention involving any human factor principles may nearly double an individual’s probability of not being readmitted. Interventions with human factor principles reduce readmissions among HF patients. Overall, this review may help reconfigure the design, implementation, and evaluation of clinical practice for reducing HF readmissions in the future.

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Authors and Affiliations

Authors

Appendix 1: Characteristics of Included Studies

Appendix 1: Characteristics of Included Studies

Authors

Year

Country

Sample (intervention)

Sample (control)

Setting

Timinga

Aguado et al.

2010

Spain

42

64

After discharge

24 months

Albert et al.

2013

US

20

26

After discharge

60 days

Aldamiz-Echevarria Iraúrgui et al.

2007

Spain

137

142

After discharge

12 months

Anderson et al.

2005

US

44

77

During hospitalizationDuring dischargeAfter discharge

6 months

Andryukhin et al.

2010

Russia

44

41

After discharge

6, 18 months

Atienza et al.

2004

Spain

164

174

During hospitalization

12 months

Belardinelli et al.

1999

US

50

49

After discharge

14 months

Benatar et al.

2003

US

108

108

After discharge

3 months

Brandon et al.

2009

US

10

10

After discharge

12 weeks

Brotons et al.

2009

Spain

144

139

After discharge

12 months

Bull et al.

2000

US

40

71

During hospitalizationAfter discharge

2 weeks, 2 months

Byszewski et al.

2010

Canada

45

46

After discharge

6 weeks

Chen et al.

2010

Taiwan

275

275

After discharge

6 months

Cline et al.

1998

Sweden

80

110

During hospitalizationAfter discharge

12 months

Cordisco et al.

1999

US

30

51

After discharge

1 year

Dahl and Penque

2001

US

381

203

During hospitalizationAfter discharge

90 days

Davidson et al.

2010

Australia

52

53

After discharge

12 months

Davis et al.

2012

US

63

62

During hospitalizationAfter discharge

30 days

Dekker et al.

2012

US

21

20

During hospitalizationAfter discharge

3 months

Delaney and Apostolidis

2010

US

12

12

After discharge

90 days

DeWalt et al.

2006

US

59

64

After discharge

12 months

Domingo et al.

2011

Spain

A = 48B = 44

N/A

After discharge

12 months

Domingues et al.

2011

Brazil

48

63

During hospitalizationAfter discharge

3 months

Doughty et al.

2002

New Zealand

100

97

After discharge

12 months

Dracup et al.

2007

US

86

87

After discharge

3, 6, 12 months

Dracup et al.

2014

US

A = 200B = 193

209

After discharge

2 years

Dunagan et al.

2005

US

76

75

After discharge

6, 12 months

Ekman et al.

2011

Sweden

125

123

During hospitalization

6 months

Evangelista et al.

2006

US

48

51

After discharge

6 months

Falces et al.

2008

Spain

53

50

During discharge

6, 12 months

Ferrante et al.

2010

Argentina

760

758

After discharge

1, 3 years

Fonarow et al.

1997

US

214

N/A

During hospitalizationAfter discharge

6 months

Gambetta et al.

2007

US

158

124

After discharge

7 months

Gámez-López et al.

2012

Spain

A = 25B = 28C = 28

35

After discharge

10.8 ± 3.2 months

Gattis et al.

1999

US

90

91

After discharge

2, 12, 24 weeks

Gau et al.

2008

Taiwan, China

30

30

During hospitalizationAfter discharge

1 month

Giordano et al.

2009

Italy

230

230

During hospitalizationAfter discharge

12 months

Goldberg et al.

2003

US

138

142

During

dischargeAfter discharge

6 months

Grundtvig et al.

2011

Norway

1169

N/A

After discharge

12 months

Hägglund et al.

2015

Sweden

32

40

After discharge

3 months

Harrison et al.

2002

Canada

92

100

After discharge

12 weeks

Heisler et al.

2013

US

135

131

During hospitalizationAfter discharge

12 months

Hershberger et al.

2001

US

108

N/A

After discharge

6 months

Ho et al.

2007

Taiwan

247

N/A

After discharge

139 ± 96 days

Holst et al.

2001

Australia

42

N/A

During hospitalizationAfter discharge

6 months

Houchen et al.

2012

UK

17

N/A

After discharge

12 months

Howlett et al.

2009

Canada

990

7741

After discharge

12 months

Hudson et al.

2005

US

91

N/A

After discharge

6 months

Jaarsma et al.

1999

Netherlands

84

95

During hospitalizationAfter discharge

9 months

Jaarsma et al.

2008

Netherlands

A = 340B = 344

339

After discharge

18 months

Jayadevappa et al.

2007

US

13

10

After discharge

6 months

Jerant et al.

2001

US

A = 12B = 13

12

After discharge

6 months

Jiang

2008

China

101

89

During hospitalizationAfter discharge

6 months

Jurgens et al.

2013

US

48

51

During dischargeAfter discharge

90 days

Kanoksilp et al.

2009

Thailand

50

50

After discharge

12 months

Kashem et al.

2008

US

24

24

After discharge

12 months

Koelling et al.

2005

US

107

116

During discharge

180 days

Korajkic et al.

2011

Australia

35

35

After discharge

3 months

Lee et al.

2013

US

23

21

After discharge

3 months

Lee et al.

2014

US

473

475

During hospitalization

30 days

Li et al.

2012

US

202

205

During hospitalization

60 days

Linden and Butterworth

2014

US

128

129

During hospitalizationAfter discharge

30, 90 days

Liou et al.

2015

Taiwan

56

75

During hospitalizationAfter discharge

30, 90 days

Löfvenmark et al.

2011

Sweden

65

63

After discharge

18 months

López-Cabezas et al.

2006

Spain

70

64

During dischargeAfter discharge

12 months

Mao et al.

2015

Taiwan

174

175

After discharge

Median 2 years

McDonald et al.

2002

Ireland

51

47

During hospitalizationAfter discharge

3 months

Mejhert et al.

2004

Sweden

103

105

After discharge

18 months

Méndez Bailón et al.

2007

Spain

51

131

During discharge

90 days

Miller and Cox

2005

US

68

N/A

After discharge

90 days, 1 year

Morcillo et al.

2005

Spain

34

36

After discharge

6 months

Naylor et al.

2004

US

118

121

During hospitalizationAfter discharge

52 weeks

Ojeda et al.

2005

Spain

76

77

After discharge

16 ± 8 months

Otsu and Moriyama

2012

Japan

47

47

After discharge

7–12, 24 months

Parrinello et al.

2009

Italy

A = 87B = 86

N/A

After discharge

12 months

Paterna et al.

2009

Italy

A = 52, B = 51, C = 51, D = 51, E = 52, F = 50, G = 52, H = 51

N/A

After discharge

6 months

Piamjariyakul et al.

2015

US

20

N/A

After discharge

6 months

Piepoli et al.

2006

Italy

509

N/A

After discharge

12 months

Pugh et al.

2001

US

27

31

During hospitalizationAfter discharge

12 months

Rich et al.

1993

US

63

35

During hospitalizationDuring dischargeAfter discharge

90 days

Rich et al.

1995

US

142

140

During hospitalizationDuring dischargeAfter discharge

90 days

Riegel et al.

2002

US

126

226

After discharge

3, 6 months

Riegel and Carlson

2004

US

45

43

After discharge

30 days, 3 months

Roig et al.

2006

Spain

61

N/A

After discharge

11 ± 10 months

Roth et al.

2004

Israel

118

N/A

After discharge

12 months

Saleh et al.

2012

US

173

160

During dischargeAfter discharge

12 months

Sales et al.

2013

US

70

67

During hospitalizationAfter discharge

30 days

Sethares and Elliott

2004

US

33

37

During hospitalizationAfter discharge

3 months

Shao and Yeh

2010

Taiwan, China

93

N/A

After discharge

1 month

Shao et al.

2013

Taiwan

47

46

After discharge

12 weeks

Sisk et al.

2006

US

203

203

After discharge

12 months

Slater et al.

2008

US

612

N/A

During hospitalizationAfter discharge

6 months

Smith et al.

2015

US

92

106

After discharge

12 months

Stewart et al.

1999

Australia

100

100

After discharge

6 months

Stewart et al.

1998

Australia

49

48

After discharge

6 months

Stewart et al.

2012

Australia

143

137

After discharge

18 months

Stewart et al.

2014

Australia

137

143

After discharge

12–18 months

Sullivan et al.

2009

US

108

100

After discharge

12 months

Sun et al.

2013

China

433

288

After discharge

4 years

Szkiladz et al.

2013

US

86

94

During dischargeAfter discharge

30 days

Tsuyuki et al.

2004

Canada

140

136

During hospitalizationAfter discharge

6 months

Tully et al.

2015

Australia

A = 15B = 14

N/A

After discharge

6 months

Varma et al.

1999

UK

42

41

After discharge

12 months

Vavouranakis et al.

2003

Greece

28

N/A

After discharge

12 months

Wang et al.

2011

Taiwan, China

14

13

During hospitalizationAfter discharge

3 months

Wang et al.

2014

China

32

34

During hospitalizationAfter discharge

6 months

West et al.

1997

US

51

N/A

After discharge

94–182 days

Wheeler and Waterhouse

2006

US

20

20

After discharge

14 weeks

White and Hill

2014

US

59

N/A

During hospitalizationAfter discharge

2 months

Witham et al.

2005

UK

41

41

After discharge

6 months

Wright et al.

2003

New Zealand

100

97

After discharge

12 months

Wu et al.

2012

US

A = 27B = 27

28

After discharge

9 months

Zeitler et al.

2015

US

1159

1172

After discharge

Every 3 months for 2 years

  1. aTiming in bold indicates outcome results used in meta-analysis

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Wan, T.T.H. (2018). Strategies to Modify the Risk for Heart Failure Readmission: A Systematic Review and Meta-analysis. In: Population Health Management for Poly Chronic Conditions. Springer, Cham. https://doi.org/10.1007/978-3-319-68056-9_6

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