Collaborative care intervention for patients with chronic heart failure: A systematic review and meta-analysis

INTRODUCTION: Patients with chronic heart failure (HF) show many symptoms that worsen the quality of life (QoL). Collaborative care intervention (CCI) aims to improve the QoL and symptoms by integrating psychosocial and palliative strategies in chronic care. METHODS: The PubMed, EMBASE, and Cochrane library databases were searched from inception to September 2018. The included studies were used to determine pooled standard mean differences (SMDs) and associated 95% confidence intervals (CIs). The data were assessed by fixed- and random effects models, respectively. RESULTS: Twenty-one studies including 2999 patients with chronic heart failure were included. The results showed significantly improved QoL in the CCI group compared with the routine care group (SMD = 0.60, 95%CI 0.27–0.94, P(heterogeneity) < .001, I(2) = 94.1%). The patients who received face-to-face interventions experienced a significant improvement (SMD = 0.54, 95%CI 0.24–0.85, P(heterogeneity) < .001, I(2) = 88.7%) in terms of QoL compared with those administered only telephone interventions. Furthermore, significantly improved anxiety level (SMD = 0.33, 95%CI 0.12–0.55, P(heterogeneity) = .612, I(2) = 0%) and 6-min walk test (SMD = 0.46, 95%CI 0.29–0.64, P(heterogeneity) = .458, I(2) = 0%) were found in the CCI group compared with the routine care group. CONCLUSION: These findings confirmed that collaborative care intervention effectively improves the quality of life as well as psychological (anxiety) and physical (6-min walk test) functions in patients with chronic heart failure compared with routine care. Furthermore, face-to-face interventions show a greater improvement of QoL compared with telephone-only interventions.