Improving Heart Failure Outcomes in Ambulatory and Community Care: A Scoping Study
| Autor: | Lorraine Jensen, Diva Turial, Sarah M. Troster, Kimberly Cai, Ji Soo Kim, Ying-Ju Ruby Chang, Dorothy Wei Yun Wang, Arlene S. Bierman, Avram Shack |
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| Rok vydání: | 2016 |
| Předmět: |
Heart Failure
medicine.medical_specialty business.industry Health Policy Clinical study design Psychological intervention Disease Management 030204 cardiovascular system & hematology Self Care 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) Systematic review Ambulatory care medicine eHealth Ambulatory Care Humans 030212 general & internal medicine Community Health Services Disease management (health) Intensive care medicine business End-of-life care |
| Zdroj: | Medical care research and review : MCRR. 74(5) |
| ISSN: | 1552-6801 |
| Popis: | Despite a large body of literature testing interventions to improve heart failure care, care is often suboptimal. This scoping study assesses organizational interventions to improve heart failure outcomes in ambulatory settings. Fifty-two studies and systematic reviews assessing multicomponent, self-management support, and eHealth interventions were included. Studies dating from the 1990s demonstrated that multicomponent interventions could reduce hospitalizations, readmissions, mortality, and costs and improve quality of life. Self-management support appeared more effective when included in multicomponent interventions. The independent contribution of eHealth interventions remains unclear. No studies addressed management of comorbidities, geriatric syndromes, frailty, or end of life care. Few studies addressed risk stratification or vulnerable populations. Limited reporting about intervention components, implementation methods, and fidelity presents challenges in adapting this literature to scale interventions. The use of standardized reporting guidelines and study designs that produce more contextual evidence would better enable application of this work in health system redesign. |
| Databáze: | OpenAIRE |
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