Effectiveness of self care intervention electronic based for improving quality of life and health outcomes in patients with heart failure: a systematic review of randomized controlled trials
DOI:
https://doi.org/10.56294/saludcyt20251365Keywords:
Heart failure, Self Care, adherence, engagement, readmission, Quality Of LifeAbstract
Background: Heart failure is a chronic disease with the highest readmission duration. Increased health costs due to heart failure also continues to increase every year. The inability to take care of selfcare and non-adherence to treatment programs are the causes of high readmissions. This study aims to identify the effectiveness of electronic-based self-care on engagement, adherence, readmission, and quality of life and also aims to identify types of self-care intervention and electronic methods or applications used in self-care. Methods: The research method is a systematic review of RCT (randomize control trial) research through systematic searches in 6 English-language databases, which were published from 2019 to 2023. Of the 134 journals identified self-care, engagement, adherence, quality of life and readmission , There are 114 articles were eliminated because they did not match the title, and of the 20 articles whose abstract results were identified as appropriate, there were 8 research references that met the inclusion and exclusion criteria, where the articles contained self-care electronic methods that were relevant to the variables in this systematic review. Data sources were taken from six data bases, namely PMC, Pubmed, Scopus, Proquest, ScienceDirect and ResearhGate. Results: The results show that the self-care intervention model electronic based has increased patient engagement (p<0.05), increasing adherence (p < 0.03), improved the quality of life of patients (p<0.05) and reduced readmissions (p<0.03) in heart failure patients. Conclusions: the conclusion is that electronic-based self-care can improve patient engagement, adherence with treatment programs, quality of life and reduce readmissions in heart failure patients.
References
1. Son, Y. J., Lee, Y., & Lee, H. J. (2020). Effectiveness of mobile phone-based interventions for improving health outcomes in patients with chronic heart failure: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 17(5), 1749
2. PERKI (2020). “Pedoman Tatalaksana Gagal Jantung” edisi tahun 2020 yang disusun oleh Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI), Jakarta
3. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145:e895–e1032. doi: 10.1161/CIR.0000000000001063 © 2022 by the American Heart Association, Inc., the American College of Cardiology Foundation, and the Heart Failure Society of America.
4. Athilingam, P., & Jenkins, B. (2018). Mobile phone apps to support heart failure self-care management: Integrative review. JMIR Cardio, 2(1) doi:http://dx.doi.org/10.2196/10057
5. Mcdonagh, theresa, et.all (2021), esc Scientific Document Group, 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal, Volume 42, Issue 36, 21 September 2021, Pages 3599–3726, https://doi.org/10.1093/eurheartj/ehab368
6. Riskesdas (2018). Laporan Nasional Riskesdas 2019, Kementrian IndonesKesehatan Republik ia.
7. Gowani, A., Gul, R., & Dhakam, S. (2018). Self-care behaviors and its influencing factors among patients with heart failure in karachi, pakistan; A mixed method study. I-Manager's Journal on Nursing, 7(4),16-26doi:http://dx.doi.org/10 .26634 /jnur. 7.4.13899
8. Zisis G, Huynh Q, Yang Y, Neil C, Carrington MJ, Ball J, Maguire G, Marwick TH. Rationale and design of a risk-guided strategy for reducing readmissions for acute decompensated heart failure: the Risk-HF study. ESC Heart Fail. 2020 Oct;7(5):3151-3160. doi: 10.1002/ehf2.12897. Epub 2020 Jul 22. PMID: 32696559; PMCID: PMC7524087
9. Ryou C, Kang SM, Jang Y. Factors associated with self-care behaviours among Koreans with heart failure. Eur J Cardiovasc Nurs. 2021 Mar 1;20(3):276–284. doi: 10.1177/1474515120934060. PMID: 33570596
10. Leavitt MA, Hain DJ, Keller KB, Newman D. Testing the Effect of a Home Health Heart Failure Intervention on Hospital Readmissions, Heart Failure Knowledge, Self-Care, and Quality of Life. J Gerontol Nurs. 2020 Feb 1;46(2):32-40. doi: 10.3928/00989134-20191118-01. PMID: 31978237
11. Pekmezaris, R., Nouryan, C.N., Schwartz, R., Castillo, S., Makaryus, A.N., Ahern, D., et al., 2019. A randomized controlled trial comparing telehealth selfmanagement to standard outpatient management in underserved black and hispanic patients living with Heart Failure.Telemed. J. Eng. Health 25, 917–925. doi:10.1089/tmj.2018.0219
12. De Oliveira FW, Nunes BP, Lobato FL, Schmidt MM. Psychoeducational Intervention for Reducing Heart Failure Patients' Rehospitalizations and Promoting Their Quality of Life and Posttraumatic Growth at the 1-Year Follow-Up: A Randomized Clinical Trial. Psychosom Med. 2023 Apr 1;85(3):273-279.doi:10.1097/PSY.0000000000001180. Epub 2023 Feb 26. PMID: 36917484
13. Toukhsati, S. R., Jaarsma, T., Babu, A. S., Driscoll, A., & Hare, D. L. (2019). Self-care interventions that reduce hospital readmissions in patients with heart failure; towards the identification of change agents. Clinical Medicine Insights: Cardiology, 13, 1179546819856855.
14. Whittal A, Störk S, Riegel B, Herber OR. Applying the COM-B behaviour model to overcome barriers to heart failure self-care: A practical application of a conceptual framework for the development of complex interventions (ACHIEVE study). Eur J Cardiovasc Nurs. 2021 Mar 1;20(3):261-267. doi: 10.1177/1474515120957292. PMID: 33909892
15. Hibbard, J. H., Stockard, J., Mahoney, E. R., & Tusler, M. (2004). Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health services research, 39(4 Pt 1), 1005–1026. https://doi.org/10.1111/j.1475-6773.2004.00269.x
16. Vellone E, Rebora P, Ausili D, Zeffiro V, Pucciarelli G, Caggianelli G, Masci S, Alvaro R, Riegel B. Motivational interviewing to improve self-care in heart failure patients (MOTIVATE-HF): a randomized controlled trial. ESC Heart Fail. 2020 Jun;7(3):1309-1318. doi: 10.1002/ehf2.12733. Epub 2020 Apr 28. PMID: 32343483; PMCID: PMC7261532
17. Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS. 2021 ACC/AHA key data elements and definitions for heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure). Circ Cardiovasc Qual Outcomes. 2021;14:e000102. doi: 10.1161/HCQ.0000000000000102
18. Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., Delling, F. N., Djousse, L., Elkind, M. S. V., Ferguson, J. F., Fornage, M., Jordan, L. C., Khan, S. S., Kissela, B. M., Knutson, K. L., & Virani, S. S. (2019). Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. In Circulation, 139(10). https://doi.org/10.1161/CIR.0000000000000659
19. Boyde, M., Peters, R., New, N., Hwang, R., Ha, T., & Korczyk, D. (2017). Self-Care Educational Intervention to Reduce Hospitalisations in Heart Failure : A Randomised Controlled Trial. European Society of Cardiology. https://doi.org/10.1177/1474515117727740
20. Bui .(2012). Home Monitoring for Heart Failure Management, Journal of the American College of Cardiology, American College of Cardiology Foundation, Vol. 59 no.2, 2012
21. Carmen KL, Dardess P, Maurer M, et al. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Affairs. 2013;32(2):223-31.
22. Clements L, Frazier SK, Lennie TA, Chung ML, Moser DK. Improvement in Heart Failure Self-Care and Patient Readmissions with Caregiver Education: A Randomized Controlled Trial. West J Nurs Res. 2023 May;45(5):402-415. doi: 10.1177/01939459221141296. Epub 2022 Dec 8. PMID: 36482693.
23. Dessie, G., Burrowes, S., Mulugeta, H., Haile, D., Negess, A., Jara, D., ... & Khanam, R. (2021). Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia. BMC cardiovascular disorders, 21(1), 1-11.
24. Dinh, H. T., Bonner, A., Ramsbotham, J., & Clark, R. (2019). Cluster randomized controlled trial testing the effectiveness of a self‐management intervention using the teach‐back method for people with heart failure. Nursing & Health Sciences, 21(4), 436-444.
25. Hammash, M. H., Crawford, T., Shawler, C., Schrader, M., Lin, C. Y., Shewekah, D., & Moser, D. K. (2017). Beyond social support: Self-care confidence is key for adherence in patients with heart failure. European Journal of Cardiovascular Nursing, 16(7), 632-637.
26. Kitsiou, S., Gerber, B. S., Kansal, M. M., Buchholz, S. W., Chen, J., Ruppar, T., ... & Pressler, S. J. (2021). Patient-centered mobile health technology intervention to improve self-care in patients with chronic heart failure: Protocol for a feasibility randomized controlled trial. Contemporary Clinical Trials, 106, 106433.
27. Oh EG, Lee JY, Lee HJ, Oh S. Effects of discharge education using teach-back methods in patients with heart failure: A randomized controlled trial. Int J Nurs Stud. 2023 Apr;140:104453. doi: 10.1016/j.ijnurstu.2023.104453. Epub 2023 Feb 4. PMID: 36827745.
28. Riegel, B.; Moser, D. K.; Anker, S. D.; Appel, L. J.; Dunbar, S. B.; Grady, K. L.; Gurvitz, M. Z.; Havranek, E. P.; Lee, C. S.; Lindenfeld, J.; Peterson, P. N.; Pressler, S. J.; Schocken, D. D.; Whellan, D. J. (2009). State of the Science: Promoting Self-Care in Persons With Heart Failure: A Scientific Statement From the American Heart Association. Circulation, 120(12), 1141–1163. doi:10.1161/CIRCULATIONAHA.109.192628
29. Seid, M. A., Abdela, O. A., & Zeleke, E. G. (2019). Adherence to self-care recommendations and associated factors among adult heart failure patients. From the patients’ point of view. PLoS One, 14(2), e0211768.
30. Yanicelli, L. M., Goy, C. B., González, V. D. C., Palacios, G. N., Martínez, E. C., & Herrera, M. C. (2021). Non-invasive home telemonitoring system for heart failure patients: A randomized clinical trial. Journal of Telemedicine and Telecare, 27(9), 553-561
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