Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
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- dc.contributor.author Checa, Caterina
- dc.contributor.author Canelo Aybar, Carlos
- dc.contributor.author Suclupe, Stefanie
- dc.contributor.author Ginesta-López, David
- dc.contributor.author Berenguera, Anna
- dc.contributor.author Castells, Xavier
- dc.contributor.author Brotons, Carlos
- dc.contributor.author Posso, Margarita
- dc.date.accessioned 2023-04-11T06:37:41Z
- dc.date.available 2023-04-11T06:37:41Z
- dc.date.issued 2022
- dc.description.abstract 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.
- dc.format.mimetype application/pdf
- dc.identifier.citation Checa C, Canelo-Aybar C, Suclupe S, Ginesta-López D, Berenguera A, Castells X, Brotons C, Posso M. Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis. Int J Environ Res Public Health. 2022 Oct 24;19(21):13823. DOI: 10.3390/ijerph192113823
- dc.identifier.doi http://dx.doi.org/10.3390/ijerph192113823
- dc.identifier.issn 1661-7827
- dc.identifier.uri http://hdl.handle.net/10230/56433
- dc.language.iso eng
- dc.publisher MDPI
- dc.relation.ispartof Int J Environ Res Public Health. 2022 Oct 24;19(21):13823
- dc.rights © 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/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Advanced heart failure
- dc.subject.keyword Case management
- dc.subject.keyword Cost-effectiveness
- dc.subject.keyword Hospital admissions
- dc.subject.keyword Meta-analyses
- dc.subject.keyword Mortality
- dc.subject.keyword Quality of life
- dc.subject.keyword Self-care
- dc.title Effectiveness and cost-effectiveness of case management in advanced heart failure patients attended in primary care: A systematic review and meta-analysis
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion