| 1. Hospital admissions / Emergency room/department visits |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
| 8.304347826086955 [-24.360869565217385, 96.79999999999997] |
Very low |
It may have little to no effect in emergency room visits but the evidence is very uncertain |
3 |
0 |
0.17 [-0.82, 1.17] |
Low |
N/A |
N/A |
Low |
| 2. Hospital admissions / HF-related hospital readmissions |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
| -18.955601659751053 [-26.450207468879697, -8.530705394190877] |
Low |
It may result in little to no difference in HF-related hospital readmissions |
3 |
0 |
-0.54 [-0.87, -0.21] |
Low |
0.0 |
N/A |
NA |
| 3. Hospital admissions / All-cause hospital readmissions |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
| -18.374999999999996 [-32.03333333333332, -1.083333333333334] |
Low |
It may result in little to no difference in all-cause hospital readmissions |
4 |
0 |
-0.25 [-0.49, -0.01] |
Moderate |
0.0 |
N/A |
NA |
| 4. Hospital admissions / All-cause hospital admissions |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
| -15.82129629629629 [-36.95092592592592, 21.33055555555555] |
Very low |
It may have little to no effect on all cause admission but the evidence is very uncertain |
4 |
0 |
-0.28 [-0.84, 0.28] |
Low |
0.0 |
N/A |
NA |
| 5. Exercise capacity (including effort test) / Exercise capacity |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 0.62 [0.09, 1.14] |
Very low |
It may increase exercise capacity but the evidence is very uncertain |
2 |
99 |
0.43 [-0.13, 0.99] |
Very low |
2.0 |
1.92 [0.43, 3.41] |
Very low |
| 6. Hospital admissions / HF-related hospital admissions |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
| -0.8690582959641255 [-20.902130044843076, 1027.7466367713018] |
Very low |
It may have little to no effect in HF-related hospital admissions but the evidence is very uncertain |
1 |
0 |
-0.04 [-3.98, 3.9] |
Low |
0.0 |
N/A |
NA |
| 7. Mortality / All causes of mortality |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
| -63.41707988980709 [-85.4633608815426, -32.97630853994486] |
Moderate |
It likely results in a large decrease mortality |
9 |
1660 |
0.5886049696783552 [0.418951549247639, 0.8269591339433623] |
Moderate |
1.0 |
0.3570069605691474 [0.13398867466880499, 0.9607894391523232] |
Moderate |
| 8. Knowledge |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 0.74 [0.08, 1.39] |
Very low |
It may increase knowledge but the evidence is very uncertain |
1 |
120 |
0.74 [0.08, 1.39] |
Low |
0.0 |
N/A |
NA |
| 9. Self-efficacy |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 0.6 [-0.22, 1.42] |
Very Low |
It may increase self-efficacy but the evidence is very uncertain |
3 |
313 |
0.6 [-0.22, 1.42] |
Low |
N/A |
N/A |
Low |
| 10. Quality of life |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 0.31 [-0.21, 0.83] |
Very low |
It may result in little to no difference in quality of life but the evidence is very uncertain |
6 |
435 |
0.21 [-0.32, 0.75] |
Very low |
2.0 |
1.84 [-0.29, 3.98] |
Very low |
Footnotes per outcome:
1) a)We rated down the certainty of evidence due to very serious risk of bias, very serious imprecision; b)Number of studies included in the network: 20 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 3 months in the studies directly comparing the self-management intervention versus usual care.
2) a)We rated down the certainty of evidence due to very serious risk of bias; b)Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 1-24 months in the studies directly comparing the self-management intervention versus usual care.
3) a)We rated down the certainty of evidence due to serious risk of bias, serious imprecision; b)Number of studies included in the network: 39 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.
4) a)We rated down the certainty of evidence due to very serious risk of bias and very serious imprecision; b)Number of studies included in the network: 45 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 3-9 months in the studies directly comparing the self-management intervention versus usual care.
5) a)We rated down due to serious imprecision, very serious risk of bias, and serious inconsistency, b)Number of studies included in the network: 34 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=52); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 0 months in the studies directly comparing the self-management intervention versus usual care.
6) a)We rated down the certainty of evidence due to very serious risk of bias, very serious imprecision; b)Number of studies included in the network: 33 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.
7) a)We rated down due to serious risk of bias; b)Number of studies included in the network: 82 RCTs; Number of studies directly comparing the intervention with usual care: 9 RCT(s) (N=823); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 1-24 months in the studies directly comparing the self-management intervention versus usual care.
8) a)We rated down the certainty of evidence due to very serious risk of bias, very serious risk of bias, and serious imprecision; b)Number of studies included in the network: 16 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=70); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 9 months in the studies directly comparing the self-management intervention versus usual care.
9) a)We rated down the certainty of evidence due to very serious risk of bias, serious imprecision; b)Number of studies included in the network: 38 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=168); Number of comparison(s) informing the indirect estimate: comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 3-9 months in the studies directly comparing the self-management intervention versus usual care.
10) a)We rated down the certainty of evidence due to very serious risk of bias, very serious risk of bias, very serious imprecision; b)Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 6 RCT(s) (N=231); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 2 - 9 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
1) Lee-2013a, Witham-2005, Young-2017c
2) Davis-2012a, Doughty-2002, Liu-2018a
3) Dewalt-2006, Doughty-2002, Ritchie-2016, Young-2017c
4) Bernocchi-2018, Lee-2013a, Witham-2012, Yu-2015
5) Gary-2010, Witham-2005
6) Otsu-2011
7) Dewalt-2006; Doughty-2002; Lee-2013a; Linden-2014; Liu-2018a; Ritchie-2016;Witham-2005;Witham-2012;Yu-2015
8) Yu-2015
9) Shao-2013; Young-2017c; Yu-2015
10) Gary-2010; Otsu-2011; Seo-2016; Wang-2016; Witham-2005; Yu-2015
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