Yang, Ya-Feng and Hoo, Jia-Xin and Tan, Jia-Yin and Lim, Lee-Ling (2023) Multicomponent integrated care for patients with chronic heart failure: systematic review and meta-analysis. ESC Heart Failure, 10 (2). pp. 791-807. ISSN 2055-5822, DOI https://doi.org/10.1002/ehf2.14207.
Full text not available from this repository.Abstract
To investigate the effectiveness of multicomponent integrated care on clinical outcomes among patients with chronic heart failure. We conducted a meta-analysis of randomized clinical trials, published in English language from inception to 20 April 2022, with at least 3-month implementation of multicomponent integrated care (defined as two or more quality improvement strategies from different domains, viz. the healthcare system, healthcare providers, and patients). The study outcomes were mortality (all-cause or cardiovascular) and healthcare utilization (hospital readmission or emergency department visits). We pooled the risk ratio (RR) using Mantel-Haenszel test. A total of 105 trials (n = 37 607 patients with chronic heart failure; mean age 67.9 +/- 7.3 years; median duration of intervention 12 months interquartile range 6-12 months]) were analysed. Compared with usual care, multicomponent integrated care was associated with reduced risk for all-cause mortality RR 0.90, 95% confidence interval (CI) 0.86-0.95], cardiovascular mortality (RR 0.73, 95% CI 0.60-0.88), all-cause hospital readmission (RR 0.95, 95% CI 0.91-1.00), heart failure-related hospital readmission (RR 0.84, 95% CI 0.79-0.89), and all-cause emergency department visits (RR 0.91, 95% CI 0.84-0.98). Heart failure-related mortality (RR 0.94, 95% CI 0.74-1.18) and cardiovascular-related hospital readmission (RR 0.90, 95% CI 0.79-1.03) were not significant. The top three quality improvement strategies for all-cause mortality were promotion of self-management (RR 0.86, 95% CI 0.79-0.93), facilitated patient-provider communication (RR 0.87, 95% CI 0.81-0.93), and e-health (RR 0.88, 95% CI 0.81-0.96). Multicomponent integrated care reduced risks for mortality (all-cause and cardiovascular related), hospital readmission (all-cause and heart failure related), and all-cause emergency department visits among patients with chronic heart failure.
| Item Type: | Article |
|---|---|
| Funders: | Ministry of Education, Malaysia, and Medical Research Council, United Kingdom (Grant Number: IF076-2019) |
| Uncontrolled Keywords: | Integrated care; Multifaceted approach; Chronic heart failure; Death; Hospitalization |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 30 Oct 2025 07:09 |
| Last Modified: | 30 Oct 2025 07:09 |
| URI: | http://eprints.um.edu.my/id/eprint/50028 |
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