Effects of Self-Care Intervention and Health Outcomes in Patients with Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

This review aimed to determine the effectiveness of self-care intervention in patients with heart failure. Methods: An electronic database search was conducted with PubMed, OVID-MEDLINE, EMBASE, CENTRAL, Google Scholar, and hand searches from February 1 to 4, 2021. Two reviewers independently selected the studies, assessed their methodological quality, and extracted relevant data. We conducted a meta-analysis of the effect of self-care versus usual care using R 4.1.0 and summarized the results of intervention from the included studies. Results: Of the 6,368 articles identified, 55 randomized control trials met the inclusion criteria for review. Self-care interventions significantly improved self-care (SMD=0.87 [95% CI: 0.70, 1.03]). In the subdomain of self-care, it was effective in improving self-care behavior (SMD=0.80 [95% CI: 0.59, 1.02]), self-care maintenance (SMD=0.99 [95% CI: 0.59, 1.38]), self-care management (SMD=1.03 [95% CI: 0.60, 1.46]), and self-care confidence (SMD=0.63 [95% CI: 0.33, 0.93]). There was a significant improvement in quality of life (SMD=0.53 [95% CI: 0.27, 0.79]) and mortality (OR=0.70 [95% CI: 0.50, 0.95]). However, the pooled effects of readmission rate (OR=0.80 [95% CI: 0.59, 1.09]) were not significant. Conclusion: This review provided evidence that self-care intervention in patients with heart failure effectively improves self-care, reduces mortality, and improves the quality of life.