Key result
Systematic review evaluates chronic disease self-management programs for reducing MACE in HFrEF.
Why the study?
Recent CHF guidelines downgraded CDSM programmes citing a lack of gold-standard evidence, prompting this systematic review to evaluate their effectiveness.
Do chronic disease self-management programmes reduce major adverse cardiovascular events in adults with heart failure with reduced ejection fraction?
Systematic Review
Do chronic disease self-management programmes reduce major adverse cardiovascular events in adults with heart failure with reduced ejection fraction?
This protocol outlines a planned systematic review to determine the efficacy of chronic disease self-management programs on clinical outcomes in patients with HFrEF.
CDSM impact on MACE in HFrEF remains unknown; protocol will synthesize RCT evidence to inform practice and trials.
INTRODUCTION: Chronic disease self-management (CDSM) is a vital component of congestive heart failure (CHF) programmes. Recent CHF guidelines have downgraded CDSM programmes citing a lack of gold-standard evidence. This protocol describes the aims and methods of a systematic review to collate and synthesise the published research evidence to determine the effectiveness of CDSM programmes and interventions for patients treated for CHF. METHODS: Medline, PubMed, Embase, CENTRAL, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO, SCOPUS, Web of Science, the Science Citation Index and registers of clinical trials will be searched from 1966 to 2024. In addition, the reference lists of shortlisted articles will be reviewed. Randomised controlled trials, with case management interventions of CDSM and CHF with reported major adverse cardiovascular events (MACEs), will be extracted and analysed. There is no restriction on language. Study protocol template developed from Cochrane Collaboration and Reporting adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines for systematic review and meta-analyses 2020. Two independent authors will apply inclusions and exclusion criteria to limit article search and assess bias and certainty of evidence rating. Data extraction and study description of included studies will include quality appraisal of studies and quantitative synthesis of data will then be undertaken to ascertain evidence for the study aims. Subgroup analyses will be conducted for different CDSM programmes. The primary outcome will be a significant change in MACE parameters between intervention and control arms. Meta-analysis will be conducted using statistical software, if feasible. ETHICS AND DISSEMINATION: Ethics approval is not sought as the study is not collecting primary patient data. The results of this study will be disseminated through peer-reviewed scientific journals and also presented to audiences through meetings and scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42023431539.
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Iyngkaran et al. (2024) conducted a systematic review in Heart failure with reduced ejection fraction (HFrEF). Chronic disease self-management (CDSM) programmes vs. Routine heart failure care or generic CHF programmes was evaluated on Change in major adverse cardiovascular events (MACE) parameters. Chronic disease self-management programs are the subject of this systematic review protocol designed to evaluate their effectiveness in reducing major adverse cardiovascular events in patients with heart failure with reduced ejection fraction.
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