Self-care interventions for adults with heart failure: A systematic review and meta-analysis protocol

Aim: To synthesize and compare outcomes from controlled trials of interventions to improve heart failure self-care among adults.

Background: Heart failure self-care interventions are recommended for preventing and detecting exacerbations, improving symptom management and preventing hospitalizations. Little is known about the overall effectiveness of heart failure self-care programmes and which types of interventions show the greatest improvement in outcomes.

Design: Systematic review and meta-analysis, including moderator analyses.

Methods: Multiple databases (including MEDLINE/PubMed, CINAHL, PsycINFO, Scopus and Cochrane Central Register of Controlled Trials) will be searched from inception through 2018 along with grey literature searches to identify trials testing interventions to improve self-care outcomes of adults with heart failure. Data will be extracted from eligible studies on sample, methodological and intervention characteristics and data to calculate effect sizes. Data will be analysed using random-effects models. Moderator variables will be analysed with meta-regression and sub-group analyses. Risk for bias will be assessed using the Cochrane Risk for Bias tool and by examining potential sources of bias as moderator variables. Funding for this project began in July 2017.

Discussion: We will analyse self-care behaviour outcomes and clinical outcomes including hospitalizations, mortality, disease severity and quality of life. This will be the most extensive meta-analysis of heart failure self-care interventions to date.

Impact: Comparative effectiveness of existing self-care interventions is not yet known. This research will identify the most promising self-care intervention components for designing better interventions and guide targeting of interventions to specific sub-populations. PROSPERO Registration Number: CRD42017075831.