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 |
-17.917391304347824 [-29.66521739130434, 3.8260869565217415] |
Very low |
It may have little to no effect in emergency room visits but the evidence is very uncertain |
4 |
0 |
-0.53 [-1.15, 0.08] |
Moderate |
N/A |
N/A |
Low |
2. 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 |
1.63 [0.85, 2.4] |
Low |
It may result in a large increase in self-efficacy |
3 |
372 |
1.85 [1.02, 2.67] |
Low |
1.0 |
-0.18 [-2.51, 2.16] |
Low |
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 |
-10.999999999999996 [-22.95833333333332, 3.31666666666667] |
Very low |
It may have little to no effect in all-cause hospital readmissions but the evidence is very uncertain |
6 |
0 |
-0.15 [-0.33, 0.04] |
Low |
0.0 |
-0.07 [-0.85, 0.7] |
Low |
4. 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 |
-1.978811659192827 [-5.85336322869956, 2.8670403587443993] |
Very low |
It may have little to no effect in HF-related hospital admissions but the evidence is very uncertain |
6 |
0 |
-0.08 [-0.3, 0.15] |
Low |
1.0 |
-1.14 [-2.71, 0.43] |
Low |
5. 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 |
0.95 [0.38, 1.51] |
Very low |
It may increase knowledge but the evidence is very uncertain |
1 |
151 |
1.12 [0.48, 1.75] |
Low |
1.0 |
0.31 [-0.93, 1.54] |
Low |
6. 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 |
-14.678838174273872 [-21.525311203319525, -5.887966804979259] |
Moderate |
It likely results in little to no difference in HF-related hospital readmissions |
4 |
0 |
-0.48 [-0.75, -0.2] |
Moderate |
2.0 |
0.1 [-0.54, 0.74] |
Low |
7. 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 |
-22.244444444444436 [-35.12314814814814, -3.778703703703704] |
Moderate |
It likely results in little to no difference on all cause admission |
7 |
0 |
-0.37 [-0.75, 0.01] |
Moderate |
1.0 |
-0.8 [-1.87, 0.27] |
Moderate |
8. 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 |
0.41 [0.08, 0.74] |
Very low |
It may have little to no effect in exercise capacity but the evidence is very uncertain |
4 |
355 |
0.4 [0.04, 0.77] |
Low |
1.0 |
0.45 [-0.33, 1.23] |
Low |
9. 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 |
0.7 [0.28, 1.11] |
Very low |
It may increase quality of life but the evidence is very uncertain |
7 |
1634 |
0.72 [0.25, 1.2] |
Very low |
2.0 |
0.62 [-0.24, 1.48] |
Very low |
10. 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 |
-0.6589531680440833 [-21.100826446280966, 23.206611570247897] |
Very low |
It may have little to no effect on mortality but the evidence is very uncertain |
13 |
3527 |
0.9900498337491681 [0.835270211411272, 1.161834242728283] |
Low |
2.0 |
1.0832870676749586 [0.6570468198150567, 1.7860384307500734] |
Low |
11. Adherence to medication or other treatment / Adherence to medication |
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 |
1.19 [0.71, 1.66] |
Low |
It may increase adherence to medication or other treatment |
2 |
288 |
1.19 [0.71, 1.66] |
Low |
0.0 |
N/A |
Low |
Footnotes per outcome:
1) a)We rated down the certainty of evidence due to 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: 4 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: 38 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=188); 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 3-6 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 inconsistency, serious imprecision; b)Number of studies included in the network: 39 RCTs; Number of studies directly comparing the intervention with usual care: 6 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. 4) a)We rated down the certainty of evidence due to serious risk of bias,serious inconsistency, very serious imprecision; b)Number of studies included in the network: 33 RCTs; Number of studies directly comparing the intervention with usual care: 6 RCT(s) (N=0); 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 6-24 months in the studies directly comparing the self-management intervention versus usual care. 5) 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=76); 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 6 months in the studies directly comparing the self-management intervention versus usual care. 6) a)We rated down the certainty of evidence due to serious risk of bias; b)Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=0); 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 6-12 months in the studies directly comparing the self-management intervention versus usual care. 7) a)We rated down the certainty of evidence due to serious risk of bias; b)Number of studies included in the network: 45 RCTs; Number of studies directly comparing the intervention with usual care: 7 RCT(s) (N=0); 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 3-24 months in the studies directly comparing the self-management intervention versus usual care. 8) a)We rated down due to serious imprecision and very serious risk of bias, b)Number of studies included in the network: 34 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=179); 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 0 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, 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: 7 RCT(s) (N=818); 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 6 - 24 months in the studies directly comparing the self-management intervention versus usual care. 10) a)We rated down due to very serious imprecision, serious risk of bias, and serious inconsistency; b)Number of studies included in the network: 82 RCTs; Number of studies directly comparing the intervention with usual care: 13 RCT(s) (N=1765); 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 3-24 months in the studies directly comparing the self-management intervention versus usual care. 11) a)We rated down the certainty of evidence due to very serious risk of bias; b)Number of studies included in the network: 8 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=144); 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.
References of studies informing direct evidence:
1) Al-Sutari-2017, Dar-2009, Sadik-2005, Villani-2014 2) Al-Sutari-2017; Mussi-2013; Sezgin-2017 3) Dunagan-2005, Holland-2007, Karlsson-2005, Krumholz-2002, Nucifora-2006, Scherr-2009 4) Dar-2009, Kalter-Leibovici-2017, Koehler-2010, Mortara-2009, Pulignano-2010, Villani-2014 5) Mussi-2013 6) Brotons-2009, Dunagan-2005, Krumholz-2002, Sezgin-2017 7) Al-Sutari-2017, Bento-2009, Dar-2009, Koehler-2010, Nguyen-2007, Pulignano-2010, Sadik-2005 8) Beckers-2010, Sadik-2005, Smolis-Bak-2015, Villani-2014 9) Brotons-2009; Karlsson-2005; Koehler-2010; Nucifora-2006; Sadik-2005; Sezgin-2017; Villani-2014 10) Al-Sutari-2017; Bento-2009; Dendale-2012; Dunagan-2005; Kalter-Leibovici-2017; Karlsson-2005;Koehler-2010;Krumholz-2002;Nguyen-2007;Nucifora-2006;Pulignano-2010;Villani-2014;Brotons-2009 11) Sadik-2005; Villani-2014
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