Abstract 15590: Effect of Home-Based Follow up Intervention on Readmissions and Mortality in Heart Failure Patients - A Meta-analysis of Randomized Controlled Trials
Introduction: Congestive heart failure (CHF) is associated with significant morbidity, recurrent re-admissions, poor overall prognosis and increased mortality. Our aim was to determine whether a home-based intervention (HBI) improves re-admissions or mortality outcomes compared to usual care for heart failure patients.
Methods: Medline Indexed and Non-indexed, Embase, and PsychINFO were searched for randomized controlled trials (RCTs).All RCTs that examined the impact of HBI in CHF patients. The studies with sample size <50 and those that used tele-medicine monitoring were excluded. Two independent investigators assessed the studies against an a priori inclusion criteria and disagreements were resolved by mutual discussion.
Results: We used reported event rates for all studies to compute cumulative odds ratio and p-value for re-admission rate and mortality. Pre-specified subgroup analysis was performed to assess the difference in readmission rate and mortality according to the length of follow-up. Summary effects were estimated using random effects models. Of 263 potentially relevant studies, a total of 20 studies (3469 patients) met our inclusion criteria and had data available on readmission rates, whereas 22 studies (3966 patients) had information regarding mortality. The pooled estimate of the included studies showed a 36% reduction in readmission rate and a 23% reduction in mortality of CHF patients who received HBI. Subgroup analysis also showed that the readmission rate decreased with the increasing length of home-based follow-up. However, mortality did not differ by the length of follow up.
Conclusions: In conclusion, our meta-analysis of RCTs shows that home-based follow up intervention in CHF patients reduces readmission rates and improves survival.
Author Disclosures: A.H. Malik: None. Y. Akram: None. S. Shetty: None. S.S. Malik: None. F.A. Syed: None. H. Nawaz: None.
- © 2014 by American Heart Association, Inc.