兰州大学循证社会科学交叉创新实验室 Innovation Laboratory of Evidence-based Social Sciences,Lanzhou University

Involving caregivers in self-management interventions for patients with heart failure and chronic obstructive pulmonary disease. A systematic review and meta-analysis

2019-12

AIM: To quantify the impact of involving caregivers in self-management interventions on health-related quality of life of patients with heart failure or chronic obstructive pulmonary disease. DESIGN: Systematic review, meta-analysis. DATA SOURCES: Searched: Medline Ebsco, PsycINFO, CINAHL, Embase, Web of Science, The British Library and ProQuest. Search time frame; January 1990-March 2018. REVIEW METHODS: Randomized controlled trials involving caregivers in self-management interventions (≥2 components) compared with usual care for patients with heart failure or chronic obstructive pulmonary disease. A matched sample based on publication year, geographic location and inclusion of an exercise intervention of studies not involving caregivers were identified. Primary outcome of analysis was patient health-related quality of life. RESULTS: Thirteen randomized controlled trials (1,701 participants: 1,439 heart failure; 262 chronic obstructive pulmonary disease) involving caregivers (mean age 59; 58% female) were identified. Reported patient health-related quality of life measures included; Minnesota Living with Heart Failure questionnaire, St. George's respiratory questionnaire and Short-Form-36. Compared with usual care, there was similar magnitude in mean improvement in patient health-related quality of life with self-management interventions in trials involving caregivers (SMD: 0.23, 95% confidence interval: -0.15-0.61) compared with trials without caregivers (SMD: 0.27, 0.08-0.46). CONCLUSION: Within the methodological constraints of this study, our results indicate that involving caregivers in self-management interventions does not result in additional improvement in patient health-related quality of life in heart failure or chronic obstructive pulmonary disease. However, involvement of caregivers in intervention delivery remains an important consideration and key area of research. IMPACT: Greater understanding and awareness is needed of the methodology of caregiver engagement in intervention development and delivery and its impact on patient outcomes.

研究类型
Meta分析
人群
混合人群
主题
["医疗服务人员","医疗护理","慢性非传染性疾病"]
作者
Miriam C Noonan , Jennifer Wingham , Hasnain M Dalal , Rod S Taylor
国家
United Kingdom
关键词
COPD; caregivers; chronic obstructive pulmonary disease; heart failure; interventions; meta-analysis; nursing; self-management; systematic review
发布日期
2019-12
相关网址
https://www.healthsystemsevidence.org/articles/62fe6fa5ef088708d8df2833-involving-caregivers-in-self-management-interventions-for-patients-with-heart-failure-and-chronic-obstructive-pulmonary-disease-a-systematic-review-and-meta-analysis?source=saved_email
DOI
10.1111/jan.14172
学科领域
DiseasesNon-communicable diseasesCardiovascular diseaseChronic obstructive pulmonary diseaseSectorsHome and community care