| 1. 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 |
| -7.1685185185185185 [-37.38518518518517, 56.34999999999998] |
Very low |
It may increase all cause admission but the evidence is very uncertain |
1 |
0 |
0.21 [-0.78, 1.19] |
Low |
1.0 |
-0.55 [-1.68, 0.59] |
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 |
| 1.3 [0.27, 2.32] |
Very Low |
It may increase self-efficacy but the evidence is very uncertain |
2 |
203 |
1.3 [0.27, 2.32] |
Low |
N/A |
N/A |
Low |
| 3. 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 |
| -8.31161825726142 [-26.413692946058116, 26.819917012448155] |
Very low |
It may have little to no effect on HF-related hospital readmissions but the evidence is very uncertain |
1 |
0 |
-0.2 [-0.86, 0.46] |
Moderate |
0.0 |
N/A |
NA |
| 4. 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 |
| -0.10833333333333062 [-16.14999999999999, 19.766666666666666] |
Low |
It may result in little to no difference in all-cause hospital readmissions |
4 |
0 |
0.0 [-0.22, 0.21] |
Moderate |
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 |
| 0.49 [-0.25, 1.23] |
Very low |
It may have little to no effect in exercise capacity but the evidence is very uncertain |
1 |
60 |
0.49 [-0.25, 1.23] |
Low |
0.0 |
N/A |
NA |
| 6. 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 |
| -23.47878787878786 [-50.925619834710695, 12.133333333333319] |
Very low |
It may decrease mortality but the evidence is very uncertain |
4 |
1447 |
0.9139311852712282 [0.697676326071031, 1.1972173631218102] |
Low |
1.0 |
0.33287108369807955 [0.13669542544552385, 0.8025187979624785] |
Low |
| 7. 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 |
| -18.382608695652166 [-34.17391304347825, 24.230434782608686] |
Very low |
It may have little to no effect in emergency room visits but the evidence is very uncertain |
1 |
0 |
-0.55 [-1.54, 0.44] |
Moderate |
N/A |
N/A |
Moderate |
| 8. 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 |
| 0.39 [-0.1, 0.89] |
Very low |
It may result in little to no difference in quality of life but the evidence is very uncertain |
6 |
1820 |
0.41 [-0.13, 0.94] |
Low |
2.0 |
0.3 [-1.05, 1.65] |
Low |
| 9. 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 |
| -0.9308295964125564 [-9.67466367713006, 14.388452914798224] |
Very low |
It may have little to no effect in HF-related hospital admissions but the evidence is very uncertain |
2 |
0 |
-0.04 [-0.61, 0.52] |
Very low |
0.0 |
N/A |
NA |
Footnotes per outcome:
1) a)We rated down the certainty of evidence due to serious risk of bias, serious incoherence, very serious imprecision; b)Number of studies included in the network: 45 RCTs; Number of studies directly comparing the intervention with usual care: 1 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 12 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, serious imprecision; b)Number of studies included in the network: 38 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=96); 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 6-12 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 and very serious imprecision; b)Number of studies included in the network: 30 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 3 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 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 2 months in the studies directly comparing the self-management intervention versus usual care.
5) 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: 1 RCT(s) (N=31); 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.
6) a)We rated down due to very serious imprecision and very serious risk of bias; b)Number of studies included in the network: 82 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=713); 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 6-12 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, very serious imprecision; b)Number of studies included in the network: 20 RCTs; Number of studies directly comparing the intervention with usual care: 1 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 7 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, 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=901); 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 - 19 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 inconsistency, very serious imprecision; b)Number of studies included in the network: 33 RCTs; Number of studies directly comparing the intervention with usual care: 2 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 6-12 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
1) Peters-Klimm-2010
2) Chen-2018d; Peters-Klimm-2010
3) Laramee-2003
4) Duffy-2010, Laramee-2003, Ong-2016, Tsuyuki-2004
5) Chen-2018d
6) Chen-2018d; Ong-2016; Peters-Klimm-2010; Tsuchihashi-Makaya-2013
7) Tsuyuki-2004
8) Chen-2018d; Clark-2015; Duffy-2010; Ong-2016; Peters-Klimm-2010; Scott-2004
9) Peters-Klimm-2010, Tsuchihashi-Makaya-2013
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