A systematic review 1 including 7 studies with a total of 3 927 subjects was abstracted in DARE. Five of the 7 studies reported improved functional status, aerobic capacity or patient satisfaction. Six of the studies reported a 50% to 85% reduction in the risk of hospital admission.
A topic in Clinical Evidence 2 summarizes the evidence on multidisciplinary interventions (nutrition, patient counselling and education). The interventions significantly reduced hospitalisation, but did not significantly reduce mortality. Analysis by intervention found that only follow-up by a multidisciplinary team reduced hospitalisations, while telephone contact plus improved coordination of primary care has no significant effect.
A systematic review 3 including 29 studies with a total of 5039 subjects was abstracted in DARE. Multidisciplinary interventions reduced the risk of all-cause mortality (RR 0.83, 95% CI: 0.70 to 0.99). Subgroup analyses revealed that this effect was limited to those programmes in which multidisciplinary teams provided specialised follow-up care (RR 0.75, 95% CI: 0.59 to 0.96). Multidisciplinary interventions reduced the all-cause hospitalisation rate (RR 0.84, 95% CI: 0.75 to 0.93), but there was statistical heterogeneity. Subgroup analyses revealed that the effect was seen in those programmes in which multidisciplinary teams provided specialised follow-up care (RR 0.81, 95% CI: 0.71 to 0.92) or self-care activities (RR 0.73, 95% CI: 0.57 to 0.93), but was not evident with those interventions that used telephone follow-up (RR 0.98, 95% CI: 0.80 to 1.20). Multidisciplinary interventions reduced the heart failure hospitalisation rate (RR 0.57, 95% CI: 0.49, 0.67).
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