Journal of Cardiac Failure
Volume 12, Issue 7 , Pages 554-567 , September 2006

A Systematic Meta-Analysis of the Efficacy and Heterogeneity of Disease Management Programs in Congestive Heart Failure

  • Alexander Göhler, MD

      Affiliations

    • From the Institute for Technology Assessment and Department of Radiology
    • Division of Cardiology, Charité Campus Virchow-Klinikum, Humboldt Medical School, Berlin, Germany
    • Department for Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
  • ,
  • James L. Januzzi, MD

      Affiliations

    • Department of Medicine and Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
  • ,
  • Stewart S. Worrell, MD, MPH

      Affiliations

    • From the Institute for Technology Assessment and Department of Radiology
  • ,
  • Karl Josef Osterziel, MD, PhD

      Affiliations

    • Division of Cardiology, Charité Campus Virchow-Klinikum, Humboldt Medical School, Berlin, Germany
  • ,
  • G. Scott Gazelle, MD, MPH, PhD

      Affiliations

    • From the Institute for Technology Assessment and Department of Radiology
    • Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts
  • ,
  • Rainer Dietz, MD, PhD

      Affiliations

    • Division of Cardiology, Charité Campus Virchow-Klinikum, Humboldt Medical School, Berlin, Germany
  • ,
  • Uwe Siebert, MD, MPH, MSc, ScD

      Affiliations

    • From the Institute for Technology Assessment and Department of Radiology
    • Department for Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
    • Corresponding Author InformationReprint requests: Uwe Siebert, MD, MPH, MSc, ScD, Associate Professor of Radiology, Director, Cardiovascular Research Program, MGH Institute for Technology Assessment, Harvard Medical School; 101 Merrimac Street, 10th floor, Boston, MA 02114-4724.

Received 15 May 2005 ,Revised 7 February 2006 ,Accepted 6 March 2006.

References 

  1. Cleland JG, Swedberg K, Follath F, Komajda M, Cohen-Solal A, Aguilar JC, et al. The EuroHeart Failure survey programme—a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J. 2003;24:442–463
  2. Jong P, Vowinckel E, Liu PP, Gong Y, Tu JV. Prognosis and determinants of survival in patients newly hospitalized for heart failure: a population-based study. Arch Intern Med. 2002;162:1689–1694
  3. Eriksson H. Heart failure: a growing public health problem. J Intern Med. 1995;237:135–141
  4. Ryden-Bergsten T, Andersson F. The health care costs of heart failure in Sweden. J Intern Med. 1999;246:275–284
  5. McMurray JJ, Petrie MC, Murdoch DR, Davie AP. Clinical epidemiology of heart failure: public and private health burden. Eur Heart J. 1998;19(Suppl P):P9–P16
  6. Grady KL, Dracup K, Kennedy G, Moser DK, Piano M, Stevenson LW, et al. Team management of patients with heart failure: a statement for healthcare professionals from The Cardiovascular Nursing Council of the American Heart Association. Circulation. 2000;102:2443–2456
  7. Stewart S, Horowitz JD. Home-based intervention in congestive heart failure: long-term implications on readmission and survival. Circulation. 2002;105:2861–2866
  8. Windham BG, Bennett RG, Gottlieb S. Care management interventions for older patients with congestive heart failure. Am J Manag Care. 2003;9:447–459
  9. Gonseth J, Guallar-Castillon P, Banegas JR, Rodriguez-Artalejo F. The effectiveness of disease management programmes in reducing hospital re-admission in older patients with heart failure: a systematic review and meta-analysis of published reports. Eur Heart J. 2004;25:1570–1595
  10. Phillips CO, Wright SM, Kern DE, Singa RM, Shepperd S, Rubin HR. Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis. [see comment] JAMA. 2004;291:1358–1367
  11. McAlister FA, Stewart S, Ferrua S, McMurray JJ. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J Am Coll Cardiol. 2004;44:810–819
  12. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–188
  13. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in metaanalyses. BMJ. 2003;327:557–560
  14. van Houwelingen HC, Arends LR, Stijnen T. Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med. 2002;21:589–624
  15. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088–1101
  16. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–634
  17. Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56:455–463
  18. Rich MW, Vinson JM, Sperry JC, Shah AS, Spinner LR, Chung MK, et al. Prevention of readmission in elderly patients with congestive heart failure: results of a prospective, randomized pilot study. J Gen Intern Med. 1993;8:585–590
  19. Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE, Carney RM. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med. 1995;333:1190–1195
  20. Cline CM, Israelsson BY, Willenheimer RB, Broms K, Erhardt LR. Cost effective management programme for heart failure reduces hospitalisation. Heart. 1998;80:442–446
  21. 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. Eur Heart J. 1998;19:1254–1260
  22. Stewart S, Pearson S, Horowitz JD. Effects of a home-based intervention among patients with congestive heart failure discharged from acute hospital care. Arch Intern Med. 1998;158:1067–1072
  23. Gattis WA, Hasselblad V, Whellan DJ, O'Connor CM. Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study. [see comment] Arch Intern Med. 1999;159:1939–1945
  24. Jaarsma T. Nurse led, multidisciplinary intervention in chronic heart failure. Heart. 1999;81:676
  25. Stewart S, Marley JE, Horowitz JD. Effects of a multidisciplinary, home-based intervention on unplanned readmissions and survival among patients with chronic congestive heart failure: a randomised controlled study. Lancet. 1999;354:1077–1083
  26. Stewart S, Vandenbroek AJ, Pearson S, Horowitz JD. Prolonged beneficial effects of a home-based intervention on unplanned readmissions and mortality among patients with congestive heart failure. [see comment] Arch Intern Med. 1999;159:257–261
  27. de Lusignan S, Wells S, Johnson P, Meredith K, Leatham E. Compliance and effectiveness of 1 year's home telemonitoring. The report of a pilot study of patients with chronic heart failure. Eur J Heart Failure. 2001;3:723–730
  28. Jerant AF, Azari R, Nesbitt TS. Reducing the cost of frequent hospital admissions for congestive heart failure: a randomized trial of a home telecare intervention. Med Care. 2001;39:1234–1245
  29. Capomolla S, Febo O, Ceresa M, Caporotondi A, Guazzotti G, La Rovere M, et al. Cost/utility ratio in chronic heart failure: comparison between heart failure management program delivered by day-hospital and usual care. [see comment] J Am Coll Cardiol. 2002;40:1259–1266
  30. Doughty RN, Wright SP, Pearl A, Walsh HJ, Muncaster S, Whalley GA, et al. Randomized, controlled trial of integrated heart failure management: the Auckland Heart Failure Management Study. Eur Heart J. 2002;23:139–146
  31. Harrison MB, Browne GB, Roberts J, Tugwell P, Gafni A, Graham ID. Quality of life of individuals with heart failure: a randomized trial of the effectiveness of two models of hospital-to-home transition. [see comment] Med Care. 2002;40:271–282
  32. Kasper EK, Gerstenblith G, Hefter G, Van Anden E, Brinker JA, Thiemann DR, et al. A randomized trial of the efficacy of multidisciplinary care in heart failure outpatients at high risk of hospital readmission. J Am Coll Cardiol. 2002;39:471–480
  33. McDonald K, Ledwidge M, Cahill J, Quigley P, Maurer B, Travers B, et al. Heart failure management: multidisciplinary care has intrinsic benefit above the optimization of medical care. J Card Fail. 2002;8:142–148
  34. Grancelli H, Varini S, Ferrante D, Schwartzman R, Zambrano C, Soifer S, et al. Randomized Trial of Telephone Intervention in Chronic Heart Failure (DIAL): study design and preliminary observations. J Card Fail. 2003;9:172–179
  35. Laramee AS, Levinsky SK, Sargent J, Ross R, Callas P. Case management in a heterogeneous congestive heart failure population: a randomized controlled trial. Arch Intern Med. 2003;163:809–817
  36. Ledwidge M, Barry M, Cahill J, Ryan E, Maurer B, Ryder M, et al. Is multidisciplinary care of heart failure cost-beneficial when combined with optimal medical care?. Eur J Heart Fail. 2003;5:381–389
  37. 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. [see comment] Eur Heart J. 2003;24:1014–1023
  38. Wright SP, Walsh H, Ingley KM, Muncaster SA, Gamble GD, Pearl A, et al. Uptake of self-management strategies in a heart failure management programme. [see comment] Eur J Heart Fail. 2003;5:371–380
  39. Atienza F, Anguita M, Martinez-Alzamora N, Osca J, Ojeda S, Almenar L, et al. Multicenter randomized trial of a comprehensive hospital discharge and outpatient heart failure management program. Eur J Heart Fail. 2004;6:643–652
  40. DeBusk RF, Miller NH, Parker KM, Bandura A, Kraemer HC, Cher DJ, et al. Care management for low-risk patients with heart failure: a randomized, controlled trial. [see comment][summary for patients in Ann Intern Med 2004;141:I58; PMID: 15492334] Ann Intern Med. 2004;141:606–613
  41. 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. J Am Geriatr Soc. 2004;52:675–684
  42. 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. J Card Fail. 2004;10:473–480
  43. Austin J, Williams R, Ross L, Moseley L, Hutchison S. Randomised controlled trial of cardiac rehabilitation in elderly patients with heart failure. Eur J Heart Fail. 2005;7:411–417
  44. Ducharme A, Doyon O, White M, Rouleau JL, Brophy JM. Impact of care at a multidisciplinary congestive heart failure clinic: a randomized trial. CMAJ. 2005;173:40–45
  45. Dunagan WC, Littenberg B, Ewald GA, Jones CA, Emery VB, Waterman BM, et al. Randomized trial of a nurse-administered, telephone-based disease management program for patients with heart failure. J Card Fail. 2005;11:358–365
  46. Ledwidge M, Ryan E, O'Loughlin C, Ryder M, Travers B, Kieran E, et al. Heart failure care in a hospital unit: a comparison of standard 3-month and extended 6-month programs. Eur J Heart Fail. 2005;7:385–391
  47. Thompson DR, Roebuck A, Stewart S. Effects of a nurse-led, clinic and home-based intervention on recurrent hospital use in chronic heart failure. Eur J Heart Fail. 2005;7:377–384
  48. Riegel B, Carlson B, Kopp Z, LePetri B, Glaser D, Unger A. Effect of a standardized nurse case-management telephone intervention on resource use in patients with chronic heart failure. Arch Intern Med. 2002;162:705–712
  49. Cleland JGF, Louis AA, Rigby AS, Janssens U, Balk AHMM. 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. J Am Coll Cardiol. 2005;45:1654–1664
  50. Blue L, Lang E, McMurray JJ, Davie AP, McDonagh TA, Murdoch DR, et al. Randomised controlled trial of specialist nurse intervention in heart failure. BMJ. 2001;323:715–718
  51. Krumholz HM, Amatruda J, Smith GL, Mattera JA, Roumanis SA, Radford MJ, et al. Randomized trial of an education and support intervention to prevent readmission of patients with heart failure. J Am Coll Cardiol. 2002;39:83–89
  52. Mejhert M, Kahan T, Persson H, Edner M. Limited long term effects of a management programme for heart failure. Heart. 2004;90:1010–1015
  53. Naylor M, Brooten D, Jones R, Lavizzo-Mourey R, Mezey M, Pauly M. Comprehensive discharge planning for the hospitalized elderly. A randomized clinical trial. Ann Intern Med. 1994;120:999–1006
  54. Naylor MD, Brooten D, Campbell R, Jacobsen BS, Mezey MD, Pauly MV, et al. Comprehensive discharge planning and home follow-up of hospitalized elders: a randomized clinical trial. [see comment] JAMA. 1999;281:613–620
  55. Oddone EZ, Weinberger M, Giobbie-Hurder A, Landsman P, Henderson W. Enhanced access to primary care for patients with congestive heart failure. Veterans Affairs Cooperative Study Group on Primary Care and Hospital Readmission. Effective Clin Practice. 1999;2:201–209
  56. Rainville EC. Impact of pharmacist interventions on hospital readmissions for heart failure. Am J Health Sys Pharm. 1999;56:1339–1342
  57. Kimmelstiel C, Levine D, Perry K, Patel AR, Sadaniantz A, Gorham N, et al. Randomized, controlled evaluation of short- and long-term benefits of heart failure disease management within a diverse provider network: the SPAN-CHF trial. Circulation. 2004;110:1450–1455
  58. Atienza F, Anguita M, Martinez-Alzamora N, Osca J, Ojeda S, Almenar L, et al. Multicenter randomized trial of a comprehensive hospital discharge and outpatient heart failure management program. Eur J Heart Fail. 2004;6:643–652
  59. Gwadry-Sridhar FH, Flintoft V, Lee DS, Lee H, Guyatt GH. A systematic review and meta-analysis of studies comparing readmission rates and mortality rates in patients with heart failure. Arch Intern Med. 2004;164:2315–2320
  60. Grancelli H, Varini S, Ferrante D, Schwartzman R, Zambrano C, Soifer S, et al. Randomized Trial of Telephone Intervention in Chronic Heart Failure (DIAL): study design and preliminary observations. J Cardiac Fail. 2003;9:172–179
  61. Yu DSF, Thompson DR, Lee DTF. Disease management programmes for older people with heart failure: crucial characteristics which improve post-discharge outcomes. Eur Heart J. 2006;27:596–612
  62. Jaarsma T, Van Der Wal MH, Hogenhuis J, Lesman I, Luttik ML, Veeger NJ, et al. Design and methodology of the COACH study: a multicenter randomised coordinating study evaluating Outcomes of Advising and Counselling in Heart failure. Eur J Heart Fail. 2004;6:227–233
  63. Gohler A, Osterziel Z, Siebert V. Long-term effectiveness and cost-effectiveness of disease management programs in congestive heart failure—a decision-analytic view. Circulation. 2004;110(S III):639

PII: S1071-9164(06)00137-0

doi: 10.1016/j.cardfail.2006.03.003

Journal of Cardiac Failure
Volume 12, Issue 7 , Pages 554-567 , September 2006