Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis

Aims: Nurse-led case management (CM) may improve quality of life (QoL) for advanced heart failure (HF) patients. No systematic review (SR), however, has summarized its effectiveness/cost-effectiveness. We aimed to evaluate the effect of such programs in primary care settings in advanced HF patients....

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Autores: Checa, Caterina, Canelo Aybar, Carlos, Suclupe, Stefanie, Ginesta-López, David, Berenguera, Anna, Castells, Xavier, Brotons, Carlos, Posso, Margarita
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/56433
Acceso en línea:http://hdl.handle.net/10230/56433
http://dx.doi.org/10.3390/ijerph192113823
Access Level:acceso abierto
Palabra clave:Advanced heart failure
Case management
Cost-effectiveness
Hospital admissions
Meta-analyses
Mortality
Quality of life
Self-care
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spelling Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysisCheca, CaterinaCanelo Aybar, CarlosSuclupe, StefanieGinesta-López, DavidBerenguera, AnnaCastells, XavierBrotons, CarlosPosso, MargaritaAdvanced heart failureCase managementCost-effectivenessHospital admissionsMeta-analysesMortalityQuality of lifeSelf-careAims: Nurse-led case management (CM) may improve quality of life (QoL) for advanced heart failure (HF) patients. No systematic review (SR), however, has summarized its effectiveness/cost-effectiveness. We aimed to evaluate the effect of such programs in primary care settings in advanced HF patients. We examined and summarized evidence on QoL, mortality, hospitalization, self-care, and cost-effectiveness. Methods and results: The MEDLINE, CINAHL, Embase, Clinical Trials, WHO, Registry of International Clinical Trials, and Central Cochrane were searched up to March 2022. The Consensus Health Economic Criteria instrument to assess risk-of-bias in economic evaluations, Cochrane risk-of-bias 2 for clinical trials, and an adaptation of Robins-I for quasi-experimental and cohort studies were employed. Results from nurse-led CM programs did not reduce mortality (RR 0.78, 95% CI 0.53 to 1.15; participants = 1345; studies = 6; I2 = 47%). They decreased HF hospitalizations (HR 0.79, 95% CI 0.68 to 0.91; participants = 1989; studies = 8; I2 = 0%) and all-cause ones (HR 0.73, 95% CI 0.60 to 0.89; participants = 1012; studies = 5; I2 = 36%). QoL improved in medium-term follow-up (SMD 0.18, 95% CI 0.05 to 0.32; participants = 1228; studies = 8; I2 = 28%), and self-care was not statistically significant improved (SMD 0.66, 95% CI -0.84 to 2.17; participants = 450; studies = 3; I2 = 97%). A wide variety of costs ranging from USD 4975 to EUR 27,538 was observed. The intervention was cost-effective at ≤EUR 60,000/QALY. Conclusions: Nurse-led CM reduces all-cause hospital admissions and HF hospitalizations but not all-cause mortality. QoL improved at medium-term follow-up. Such programs could be cost-effective in high-income countries.MDPI202320232022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/56433http://dx.doi.org/10.3390/ijerph192113823reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésInt J Environ Res Public Health. 2022 Oct 24;19(21):13823© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/564332026-05-29T05:05:01Z
dc.title.none.fl_str_mv Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
title Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
spellingShingle Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
Checa, Caterina
Advanced heart failure
Case management
Cost-effectiveness
Hospital admissions
Meta-analyses
Mortality
Quality of life
Self-care
title_short Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
title_full Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
title_fullStr Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
title_full_unstemmed Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
title_sort Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
dc.creator.none.fl_str_mv Checa, Caterina
Canelo Aybar, Carlos
Suclupe, Stefanie
Ginesta-López, David
Berenguera, Anna
Castells, Xavier
Brotons, Carlos
Posso, Margarita
author Checa, Caterina
author_facet Checa, Caterina
Canelo Aybar, Carlos
Suclupe, Stefanie
Ginesta-López, David
Berenguera, Anna
Castells, Xavier
Brotons, Carlos
Posso, Margarita
author_role author
author2 Canelo Aybar, Carlos
Suclupe, Stefanie
Ginesta-López, David
Berenguera, Anna
Castells, Xavier
Brotons, Carlos
Posso, Margarita
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Advanced heart failure
Case management
Cost-effectiveness
Hospital admissions
Meta-analyses
Mortality
Quality of life
Self-care
topic Advanced heart failure
Case management
Cost-effectiveness
Hospital admissions
Meta-analyses
Mortality
Quality of life
Self-care
description Aims: Nurse-led case management (CM) may improve quality of life (QoL) for advanced heart failure (HF) patients. No systematic review (SR), however, has summarized its effectiveness/cost-effectiveness. We aimed to evaluate the effect of such programs in primary care settings in advanced HF patients. We examined and summarized evidence on QoL, mortality, hospitalization, self-care, and cost-effectiveness. Methods and results: The MEDLINE, CINAHL, Embase, Clinical Trials, WHO, Registry of International Clinical Trials, and Central Cochrane were searched up to March 2022. The Consensus Health Economic Criteria instrument to assess risk-of-bias in economic evaluations, Cochrane risk-of-bias 2 for clinical trials, and an adaptation of Robins-I for quasi-experimental and cohort studies were employed. Results from nurse-led CM programs did not reduce mortality (RR 0.78, 95% CI 0.53 to 1.15; participants = 1345; studies = 6; I2 = 47%). They decreased HF hospitalizations (HR 0.79, 95% CI 0.68 to 0.91; participants = 1989; studies = 8; I2 = 0%) and all-cause ones (HR 0.73, 95% CI 0.60 to 0.89; participants = 1012; studies = 5; I2 = 36%). QoL improved in medium-term follow-up (SMD 0.18, 95% CI 0.05 to 0.32; participants = 1228; studies = 8; I2 = 28%), and self-care was not statistically significant improved (SMD 0.66, 95% CI -0.84 to 2.17; participants = 450; studies = 3; I2 = 97%). A wide variety of costs ranging from USD 4975 to EUR 27,538 was observed. The intervention was cost-effective at ≤EUR 60,000/QALY. Conclusions: Nurse-led CM reduces all-cause hospital admissions and HF hospitalizations but not all-cause mortality. QoL improved at medium-term follow-up. Such programs could be cost-effective in high-income countries.
publishDate 2022
dc.date.none.fl_str_mv 2022
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/56433
http://dx.doi.org/10.3390/ijerph192113823
url http://hdl.handle.net/10230/56433
http://dx.doi.org/10.3390/ijerph192113823
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Int J Environ Res Public Health. 2022 Oct 24;19(21):13823
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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