Metaanalysis and review of heart failure disease management randomized controlled clinical trials

David J. Whellan, Vic Hasselblad, Eric Peterson, Christopher M. O'Connor, Kevin A. Schulman

Research output: Contribution to journalArticlepeer-review

146 Scopus citations

Abstract

Background: The medical community has turned to disease management (DM) to bridge the gap between proven therapies and clinical practice for patients with heart failure (HF). The aim of this study was to assess the effectiveness of DM programs in reducing hospitalization and mortality in patients with HF on the basis of the results of existing trials. Methods: We compared the published results from 19 randomized controlled clinical trials evaluating HF DM programs. A random effects model was used to combine the hazards ratio for all-cause hospitalization across the studies evaluating specific types of HF DM programs. Results: We identified 19 relevant studies, with 5752 enrolled patients, which assessed the benefits of HF DM programs. The overall effect was a significant decrease in all-cause hospitalization for patients with HF. There was significant heterogeneity in the results (P < .0001). Conclusions: The results of this analysis indicate that HF DM is an intervention that could significantly decrease hospitalization for patients with HF. However, due to differences in the types of strategies and the variety of health care settings in which they were evaluated, further studies of HF DM programs with multiple participating centers are required.

Original languageEnglish (US)
Pages (from-to)722-729
Number of pages8
JournalAmerican heart journal
Volume149
Issue number4
DOIs
StatePublished - Apr 2005
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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