Key result
Motivational interventions improve HF self-care maintenance while knowledge and monitoring strategies improve self-care management.
Why the study?
The comparative effectiveness of different intervention strategies for improving self-care maintenance, self-care management, and self-care confidence in adults with heart failure was unclear.
Do different self-care intervention strategies improve self-care maintenance, management, and confidence in adults with heart failure?
Meta-Analysis (n=6,508)
Do different self-care intervention strategies improve self-care maintenance, management, and confidence in adults with heart failure?
Different self-care interventions in heart failure are not equally effective across domains, with motivational approaches best for maintenance and knowledge/monitoring best for management.
Supports domain-specific selection of self-care strategies in heart failure; extends randomized evidence through network meta-analysis of intervention types.
Aim To compare the effectiveness of different intervention strategies for improving self‐care maintenance, self‐care management and self‐care confidence in adults with heart failure. Design Systematic review and network meta‐analysis. Methods Following PRISMA‐NMA guidelines, randomised controlled trials evaluating heart failure self‐care interventions were included. Self‐care was assessed using the Self‐Care of Heart Failure Index across the eligible studies. Interventions were classified as knowledge/cognition‐oriented, skill/behaviour‐oriented, monitoring/feedback‐reinforcement, motivation/empowerment‐oriented or multicomponent. Risk of bias was assessed with RoB 2. Pairwise meta‐analyses and exploratory network meta‐analyses were performed. Data Sources PubMed, Embase, Scopus, Web of Science, CENTRAL, CINAHL and PsycINFO were searched from inception to March 2025. Results Fifty‐four trials involving 6508 participants were included, of which 32 contributed to the meta‐analysis. In pairwise meta‐analysis, motivation/empowerment‐oriented and skill/behaviour‐oriented interventions improved self‐care maintenance, whereas knowledge/cognition‐oriented, monitoring/feedback‐reinforcement and motivation/empowerment‐oriented interventions improved self‐care management. Multicomponent interventions improved maintenance, management and confidence, but were not clearly superior to more focused strategies. Subgroup analyses suggested greater benefits from personalised provider feedback than from predominantly automated feedback. Exploratory network meta‐analysis showed similar patterns, although rankings should be interpreted cautiously because the network was star‐shaped and lacked direct comparisons between active interventions. Conclusions Heart failure self‐care interventions are not equally effective across domains. Motivation/empowerment‐oriented approaches showed the clearest signal for self‐care maintenance, whereas knowledge‐based and personalised monitoring/feedback strategies appeared more relevant for self‐care management. These findings support a more targeted approach to intervention design. Implications for the Profession Healthcare professionals should tailor strategies to specific self‐care goals, prioritising motivational techniques for maintenance, structured education and monitoring with personalised feedback for management. Patient or Public Contribution No patient or public involvement. Trial Number CRD420250652676
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Zou et al. (2026) conducted a meta-analysis in heart failure (n=6,508). Self-care interventions vs. Control or other active interventions was evaluated on Self-care maintenance, self-care management and self-care confidence. Motivation/empowerment-oriented interventions improved self-care maintenance, while knowledge-based and personalised monitoring/feedback strategies improved self-care management in heart failure.
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