Ref (type) | Population | Outcome, Interventions | Results and statistical analysis | Effect size | Favours |
All-cause mortality | |||||
[15]
Systematic review |
5308 people 28 RCTs in this analysis |
Rate of all-cause mortality
389/2587 (15%) with disease management programme 492/2721 (18%) with usual care |
OR 0.80 95% CI 0.69 to 0.93 P = 0.003 RCTs of multidisciplinary treatment were generally small, involving highly selected patient populations (see further information on studies for more details) |
Small effect size | disease management programme |
[16]
Systematic review |
Number of people in analysis not reported 30 RCTs in this analysis |
Rate of all-cause mortality
with disease management programme with usual care Absolute results not reported |
ARR –3% 95% CI –5% to –1% P <0.01 Benefit of the intervention was dependent on age, severity of disease, guideline-based treatment at baseline, and disease management programme modalities |
Effect size not calculated | disease management programme |
[17]
Systematic review |
7532 people 27 RCTs in this analysis |
Rate of all-cause mortality
613/3867 (16%) with multidisciplinary programme 661/3580 (18%) with control (not further defined) |
RR 0.79 95% CI 0.69 to 0.92 P = 0.002 There was significant heterogeneity among RCTs (P = 0.04); the review identified 2 RCTs that were outliers as potential sources of heterogeneity |
Small effect size | multidisciplinary programme |
[17]
Systematic review |
7213 people 26 RCTs in this analysis Sensitivity analysis |
Rate of all-cause mortality
with multidisciplinary programme with control (not further defined) Absolute results not reported |
RR 0.83 95% CI 0.73 to 0.95 P = 0.002 Sensitivity analysis excluding 1 outlier removed heterogeneity with only a small reduction in results for effectiveness |
Small effect size | multidisciplinary programme |
[17]
Systematic review |
553 people 3 RCTs in this analysis Subgroup analysis |
Rate of all-cause mortality
35/316 (11%) with televideo or remote monitoring-based programme 51/237 (22%) with control (not further defined) |
RR 0.49 95% CI 0.33 to 0.73 P = 0.0004 |
Moderate effect size | televideo or remote monitoring-based programme |
[17]
Systematic review |
3384 people 11 RCTs in this analysis Subgroup analysis |
Rate of all-cause mortality
220/1679 (13%) with programmes incorporating contact by telephone or mail 279/1705 (16%) with control (not further defined) |
RR 0.70 95% CI 0.53 to 0.94 P = 0.02 |
Small effect size | programmes incorporating contact by telephone or mail |
[17]
Systematic review |
1811 people 11 RCTs in this analysis Subgroup analysis |
Rate of all-cause mortality
149/890 (17%) with programmes consisting of home visits 183/921 (20%) with control (not further defined) |
RR 0.87 95% CI 0.72 to 1.06 P = 0.17 |
Not significant | |
[17]
Systematic review |
1784 people 3 RCTs in this analysis Subgroup analysis |
Rate of all-cause mortality
209/982 (21.3%) with programmes delivered in hospital, clinic, or general practice 170/802 (21.2%) with control (not further defined) |
RR 1.00 95% CI 0.84 to 1.20 P = 0.98 |
Not significant | |
[18]
Systematic review |
3918 people 22 RCTs in this analysis |
Rate of all-cause mortality
with multidisciplinary programmes with control (predominantly usual care) Absolute results not reported |
OR 0.69 95% CI 0.56 to 0.85 |
Small effect size | multidisciplinary programme |
[18]
Systematic review |
Number of RCTs and people included in subgroup analysis not reported Subgroup analysis |
Rate of all-cause mortality
with programmes involving face-to-face contact with control (predominantly usual care) Absolute results not reported |
OR 0.63 95% CI 0.44 to 0.91 |
Small effect size | programmes involving face-to-face contact |
[18]
Systematic review |
Number of RCTs and people included in subgroup analysis not reported Subgroup analysis |
Rate of all-cause mortality
with programmes involving face-to-face contact plus telephone contact with control (predominantly usual care) Absolute results not reported |
OR 0.68 95% CI 0.44 to 1.06 |
Not significant | |
[18]
Systematic review |
Number of RCTs and people included in subgroup analysis not reported Subgroup analysis |
Rate of all-cause mortality
with programmes involving telephone (non face-to-face) management with control (predominantly usual care) Absolute results not reported |
OR 0.82 95% CI 0.48 to 1.40 |
Not significant | |
[19]
Systematic review |
2060 people 12 RCTs in this analysis |
Rate of all-cause mortality
117/1001 (12%) with pharmacist care 136/1059 (13%) with no pharmacist care |
OR 0.84 95% CI 0.61 to 1.15 |
Not significant | |
[20]
Systematic review |
6133 people 19 RCTs in this analysis |
All-cause mortality
390/3320 (12%) with remote patient monitoring 397/2813 (14%) with usual care |
RR 0.83 95% CI 0.73 to 0.95 P = 0.006 |
Small effect size | remote patient monitoring |
[21]
Systematic review |
5563 people 15 RCTs in this analysis |
All-cause mortality
332/2948 (11%) with structured telephone support 332/2615 (13%) with usual care |
RR 0.88 95% CI 0.76 to 1.01 P = 0.08 |
Not significant | |
[21]
Systematic review |
2710 people 11 RCTs in this analysis |
All-cause mortality
147/1410 (10%) with telemonitoring 200/1300 (15%) with usual care |
RR 0.66 95% CI 0.54 to 0.81 P = 0.00005 |
Small effect size | telemonitoring |
[22]
RCT 3-armed trial |
1049 people hospitalised because of heart failure, New York Heart Association (NYHA) functional class II to IV |
Rate of all-cause mortality
18 months
83/344 (24%) with intensive disease management programme 99/339 (29%) with usual care |
Significance not assessed The RCT was not powered to assess mortality alone The results from this large RCT do not correlate with the results of the 6 systematic reviews reported (see further information on studies for details) |
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[23]
RCT |
1518 people having outpatient care for stable chronic heart failure with mainly NYHA class II or III symptoms |
All-cause mortality
up to 1 year after completion of the trial
189/760 (25%) with previous telephone monitoring by specialised nurses 197/758 (26%) with previous usual care |
RR 0.94 95% CI 0.77 to 1.16 P = 0.59 |
Not significant | |
[23]
RCT |
1518 people having outpatient care for stable chronic heart failure with mainly NYHA class II or III symptoms |
All-cause mortality
up to 3 years after completion of the trial
326/760 (43%) with previous telephone monitoring by specialised nurses 308/758 (41%) with previous usual care |
RR 1.02 95% CI 0.87 to 1.20 P = 0.73 |
Not significant |