Quality of life in patients receiving telemedicine enhanced chronic heart failure disease management: A meta-analysis

Background Previous reviews have investigated the effectiveness of telemedicine in the treatment of heart failure (HF). Dependent variables have included hospitalisations, mortality rates, disease knowledge and health costs. Few reviews, however, have examined the variable of health-related quality of life (QoL). Methods Randomised controlled trials comparing the delivery methods of any form of telemedicine with usual care for the provision of HF disease-management were identified via searches of all relevant databases and reference lists. Studies had to report a quantitative measure for mental, physical or overall QoL in order to be included. Results A total of 33 studies were identified. However, poor reporting of data resulted in the exclusion of seven, leaving 26 studies with 7066 participants. Three separate, random effects meta-analyses were conducted for mental, physical and overall QoL. Telemedicine was not significantly more effective than usual care on mental and physical QoL (standardised mean difference (SMD) 0.03, (95% confidence interval (CI) −0.05–0.12), p = 0.45 and SMD 0.24, (95% CI −0.08–0.56), p = 0.14, respectively). However, when compared to usual care, telemedicine was associated with a small significant increase in overall QoL (SMD 0.23, (95% CI 0.09–0.37), p = 0.001). Moderator analyses indicated that telemedicine delivered over a long-duration (≥52 weeks) and via telemonitoring was most beneficial. Conclusion Compared to usual care, telemedicine significantly increases overall QoL in patients receiving HF disease management. Statistically non-significant but nonetheless positive trends were also observed for physical QoL. These findings provide preliminary support for the use of telemedicine in the management of heart failure without jeopardising patient well-being.

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Effectiveness of comprehensive geriatric assessment intervention on quality of life, caregiver burden and length of hospital stay: a systematic review and meta-analysis of randomised controlled trials

BMC Geriatrics ◽

10.1186/s12877-021-02319-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhongyi Chen ◽

Zhaosheng Ding ◽

Caixia Chen ◽

Yangfan Sun ◽

Yuyu Jiang ◽

...

Keyword(s):

Quality Of Life ◽

Hospital Stay ◽

Usual Care ◽

Caregiver Burden ◽

Length Of Hospital Stay ◽

Sf 36 ◽

Subgroup Analyses ◽

Randomised Controlled ◽

Meta Analyses

Abstract Background Comprehensive geriatric assessment (CGA) interventions can improve functional ability and reduce mortality in older adults, but the effectiveness of CGA intervention on the quality of life, caregiver burden, and length of hospital stay remains unclear. The study aimed to determine the effectiveness of CGA intervention on the quality of life, length of hospital stay, and caregiver burden in older adults by conducting meta-analyses of randomised controlled trials (RCTs). Methods A literature search in PubMed, Embase, and Cochrane Library was conducted for papers published before February 29, 2020, based on inclusion criteria. Standardised mean difference (SMD) or mean difference (MD) with 95% confidence intervals (CIs) was calculated using the random-effects model. Subgroup analyses, sensitivity analyses, and publication bias analyses were also conducted. Results A total of 28 RCTs were included. Overall, the intervention components common in different CGA intervention models were interdisciplinary assessments and team meetings. Meta-analyses showed that CGA interventions improved the quality of life of older people (SMD = 0.12; 95% CI = 0.03 to 0.21; P = 0.009) compared to usual care, and subgroup analyses showed that CGA interventions improved the quality of life only in participants’ age > 80 years and at follow-up ≤3 months. The change value of quality of life in the CGA intervention group was better than that in the usual care group on six dimensions of the 36-Item Short-Form Health Survey questionnaire (SF-36). Also, compared to usual care, the CGA intervention reduced the caregiver burden (SMD = − 0.56; 95% CI = − 0.97 to − 0.15, P = 0.007), but had no significant effect on the length of hospital stay. Conclusions CGA intervention was effective in improving the quality of life and reducing caregiver burden, but did not affect the length of hospital stay. It is recommended that future studies apply the SF-36 to evaluate the impact of CGA interventions on the quality of life and provide supportive strategies for caregivers as an essential part of the CGA intervention, to find additional benefits of CGA interventions.

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Quality of Life Is Improved in Uninsured Heart Failure Patients in Disease Management Programs in Public Hospitals

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2010.06.018 ◽

2010 ◽

Vol 16 (8) ◽

pp. S6

Author(s):

Aurelia O'Connell ◽

Tracy Finegan ◽

Jennifer Galindo ◽

Gisele Munoz ◽

Andrene Schonberg ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Disease Management ◽

Public Hospitals ◽

Disease Management Programs ◽

Heart Failure Patients

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Evaluating the provision of Further Enabling Care at Home (FECH+) for informal caregivers of older adults discharged home from hospital: protocol for a multicentre randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-046600 ◽

2021 ◽

Vol 11 (6) ◽

pp. e046600

Author(s):

Anne-Marie Hill ◽

Rachael Moorin ◽

Susan Slatyer ◽

Christina Bryant ◽

Keith Hill ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Randomised Controlled Trial ◽

Usual Care ◽

Controlled Trial ◽

Informal Caregivers ◽

Care Recipient ◽

Care At Home ◽

Randomised Controlled

IntroductionThere are personal and societal benefits from caregiving; however, caregiving can jeopardise caregivers’ health. The Further Enabling Care at Home (FECH+) programme provides structured nurse support, through telephone outreach, to informal caregivers of older adults following discharge from acute hospital care to home. The trial aims to evaluate the efficacy of the FECH+ programme on caregivers’ health-related quality of life (HRQOL) after care recipients’ hospital discharge.Methods and analysisA multisite, parallel-group, randomised controlled trial with blinded baseline and outcome assessment and intention-to-treat analysis, adhering to Consolidated Standards of Reporting Trials guidelines will be conducted. Participants (N=925 dyads) comprising informal home caregiver (18 years or older) and care recipient (70 years or older) will be recruited when the care recipient is discharged from hospital. Caregivers of patients discharged from wards in three hospitals in Australia (one in Western Australia and two in Queensland) are eligible for inclusion. Participants will be randomly assigned to one of the two groups. The intervention group receive the FECH+ programme, which provides structured support and problem-solving for the caregiver after the care recipient’s discharge, in addition to usual care. The control group receives usual care. The programme is delivered by a registered nurse and comprises six 30–45 min telephone support sessions over 6 months. The primary outcome is caregivers’ HRQOL measured using the Assessment of Quality of Life—eight dimensions. Secondary outcomes include caregiver preparedness, strain and distress and use of healthcare services. Changes in HRQOL between groups will be compared using a mixed regression model that accounts for the correlation between repeated measurements.Ethics and disseminationParticipants will provide written informed consent. Ethics approvals have been obtained from Sir Charles Gairdner and Osborne Park Health Care Group, Curtin University, Griffith University, Gold Coast Health Service and government health data linkage services. Findings will be disseminated through presentations, peer-reviewed journals and conferences.Trial registration numberACTRN12620000060943.

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The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

Palliative Medicine ◽

10.1177/0269216321994728 ◽

2021 ◽

pp. 026921632199472

Author(s):

Natalia Salamanca-Balen ◽

Thomas V Merluzzi ◽

Man Chen

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Palliative Care ◽

Meta Analysis ◽

Symptom Burden ◽

Well Being ◽

Medium Effect ◽

Spiritual Well Being ◽

Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

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Does Symptom Recognition Improve Self-Care in Patients with Heart Failure? A Pilot Study Randomised Controlled Trial

Nursing Reports ◽

10.3390/nursrep11020040 ◽

2021 ◽

Vol 11 (2) ◽

pp. 418-429

Author(s):

Joana Pereira Sousa ◽

Hugo Neves ◽

Miguel Pais-Vieira

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Care Management ◽

Controlled Trial ◽

Self Care ◽

Fluid Restriction ◽

Symptom Recognition ◽

Patients With Heart Failure ◽

Randomised Controlled

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group = −0.881; p < 0.001) and in the quality of life (βSlope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure. This randomised controlled trial was retrospectively registered (NCT04892004).

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A Systematic Literature Review on the Importance of Anthropometric Data Toward the Malaysian Population Productivity and Quality of Life

Studies of Applied Economics ◽

10.25115/eea.v39i10.5345 ◽

2021 ◽

Vol 39 (10) ◽

Author(s):

Nurashikin Saaludin ◽

Amna Saad ◽

Cordelia Mason ◽

Norsaadah Zakaria

Keyword(s):

Quality Of Life ◽

Well Being ◽

Anthropometric Data ◽

Identity Verification ◽

Medical Treatments ◽

Car Seat ◽

Safety Work ◽

Conducting Research ◽

Meta Analyses

Anthropometric data is widely used in various applications such as manufacturing, healthcare, forensics, and medical treatments. In addition, the data can be applied to design ergonomic tools, equipment, clothing, and footwear to ensure that the products, facilities, and services fit the users. This paper aims to analyze the existing literature on the importance of anthropometric data on the Malaysian population's productivity and quality of life and look into any further research that needs improvement. Guided by the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), through Scopus and Web of Science databases, 15 related studies were identified. The review managed to extract six applications of anthropometric data and its seven perceived benefits. Data applications were classified into furniture, clothing and footwear, car seat, fitting and fixture, forensic investigation, and safety products. The benefits were grouped into easy to use, fit, well-being, welfare, safety, work efficiency, and identity verification by using thematic analysis. The review also highlighted the methodological issues related to the number of samples, locations coverage for a survey and the financial support in conducting research. Finally, several recommendations were drawn, including the importance of anthropometric database development at the end of this paper for reference by future scholars.

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Effects of five types of selenium supplementation for treatment of Kashin-Beck disease in children: a systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-017883 ◽

2018 ◽

Vol 8 (3) ◽

pp. e017883 ◽

Cited By ~ 6

Author(s):

Dongmei Xie ◽

Yulin Liao ◽

Jirong Yue ◽

Chao Zhang ◽

Yanyan Wang ◽

...

Keyword(s):

Sodium Selenite ◽

Meta Analysis ◽

Selenium Supplementation ◽

Assessment Development ◽

Registration Number ◽

Selenium Supplements ◽

Randomised Controlled ◽

Meta Analyses ◽

Beck Disease

ObjectiveTo compare the effectiveness of five kinds of selenium supplementation for the treatment of patients with Kashin-Beck disease, and rank these selenium supplementations based on their performance.DesignWe searched for all publications between 1 January 1966 and 31 March 2017 using seven electronic databases. GRADE system to network meta-analyses (NMAs) was applied to rate the quality of the evidence. We conducted a random effects model NMA in STATA 12.1 to determine comparative effectiveness of each intervention. Rankings were obtained by using the surface under the cumulative ranking curve (SUCRA) values and mean ranks.ResultsA total of 15 randomised controlled trials involving 2931 patients were included. After assessment of the overall quality of the evidence, we downgraded our primary outcomes from high to low or very low quality. NMAs showed that all five kinds of selenium supplementation had higher metaphysis X-ray improvement which were superior to placebo. Ranking on efficacy indicated that selenium salt was ranked the highest, followed by sodium selenite + vitamin E, selenium enriched yeast, sodium selenite and then sodium selenite + vitamin C.ConclusionsBased on the results of NMA, all five types of selenium supplements are more effective than placebo and so that selenium supplementation is of help in repairing metaphyseal lesions. Since the overall quality of the evidence was low or very low, the SUCRA values may be misleading and should be considered jointly with the The Grading of Recommendations Assessment, Development and Evaluation (GRADE) confidence in the estimates for each comparison. The quality of the evidence is insufficient to draw a conclusion about what method of selenium supplementation is most effective.PROSPERO registration numberCRD42016051874.

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Music therapy effectiveness by duration in patients with cancer: a meta-regression

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2021-003163 ◽

2021 ◽

pp. bmjspcare-2021-003163

Author(s):

Ronald Chow ◽

Robert Bergner ◽

Elizabeth Prsic

Keyword(s):

Quality Of Life ◽

Music Therapy ◽

Positive Association ◽

Well Being ◽

Patients With Cancer ◽

Therapy Effectiveness ◽

Meta Regression ◽

Meta Analyses ◽

The Impact

ObjectivesSeveral reviews and meta-analyses have reported on music therapy for physical and emotional well-being among patients with cancer. However, the duration of music therapy offered may range from less than 1 hour to several hours. The aim of this study is to assess whether longer duration of music therapy is associated with different levels of improvement in physical and mental well-being.MethodsTen studies were included in this paper, reporting on the endpoints of quality of life and pain. A meta-regression, using an inverse-variance model, was performed to assess the impact of total music therapy time. A sensitivity analysis was conducted for the outcome of pain, among low risk of bias trials.ResultsOur meta-regression found a trend for positive association between greater total music therapy time and improved better pain control, but it was not statistically significant.ConclusionThere is a need for more high-quality studies examining music therapy for patients with cancer, with a focus on total music therapy time and patient-related outcomes including quality of life and pain.

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Abstract P229: Benefits of Tai Chi Exercise Among Adults With Chronic Heart Failure: A Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.141.suppl_1.p229 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Ruth E Taylor-Piliae ◽

Brooke A Finley

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Systematic Review ◽

Exercise Capacity ◽

Tai Chi ◽

Meta Analysis ◽

Quality Score ◽

Study Quality ◽

Tai Chi Exercise

Background: Regular exercise is beneficial for adults with chronic heart failure (CHF). Tai Chi is popular among older adults and may offer additional exercise options for those with CHF. Objectives: A systematic review and meta-analysis was conducted to examine the benefits of Tai Chi exercise among adults with CHF. Methods: An electronic literature search of ten databases (AMED, CINAHL, Embase, OpenGrey, PsycARTICLES, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science) was conducted from January 1, 2004 to August 1, 2019. Clinical trials that examined Tai Chi exercise, were published in English or German languages, among participants with CHF were included. Study quality was assessed independently by two reviewers, using the modified Downs and Black Quality Index checklist (low quality = score ≤14, moderate quality = score 15-23, high quality = score ≥ 24). Comprehensive Meta-Analysis version 2.0 software (Biostat, Inc.) was used to calculate the effect sizes (i.e., Hedges’ g) and the 95% confidence intervals using random effects models. Results: A total of six studies met the inclusion criteria (five RCTs and one quasi-experimental study with a comparison group), enrolling 229 participants (mean age=68 years old, 28% women, mean ejection fraction=37%). The Yang style of Tai Chi was most commonly practiced in these studies (n=5, 83%), with usual care the most common control condition. Study quality was moderate (mean score=23). At least three studies reported outcomes for exercise capacity, quality of life (QOL), depression, and b-type natriuretic peptide (BNP), allowing for meta-analysis. Compared to controls, Tai Chi participants had significantly better exercise capacity (Hedge’s g=0.353; p=0.026, I 2 =32.72%), improved QOL (Hedge’s g=0.617; p=0.000, I 2 =0%), with less depression (Hedge’s g=0.627; p=0.000, I 2 =0%), and decreased BNP expression (Hedge’s g=0.333; p=0.016, I 2 =0%). Conclusion: Among adults with CHF, Tai Chi was effective in improving exercise capacity and quality of life, with less depression and BNP levels observed, when compared to controls. Tai Chi is popular and safe form of exercise among older adults, yet few studies have been conducted during the past 15 years examining the benefits of Tai Chi among adults with CHF. Tai Chi can be easily integrated into existing cardiac rehabilitation programs. Further research is needed with more rigorous study designs and larger samples, before widespread recommendations can be made.

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Natriuretic peptide-guided treatment for heart failure: a systematic review and meta-analysis

BMJ evidence-based medicine ◽

10.1136/bmjebm-2019-111208 ◽

2019 ◽

Vol 25 (1) ◽

pp. 33-37 ◽

Cited By ~ 1

Author(s):

Julie McLellan ◽

Clare R Bankhead ◽

Jason L Oke ◽

F D Richard Hobbs ◽

Clare J Taylor ◽

...

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Natriuretic Peptide ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Individual Outcomes ◽

All Cause Mortality ◽

Registration Number ◽

Randomised Controlled ◽

Meta Analyses

BackgroundGUIDE-IT, the largest trial to date, published in August 2017, evaluating the effectiveness of natriuretic peptide (NP)-guided treatment of heart failure (HF), was stopped early for futility on a composite outcome. However, the reported effect sizes on individual outcomes of all-cause mortality and HF admissions are potentially clinically relevant.ObjectiveThis systematic review and meta-analysis aims to combine all available trial level evidence to determine if NP-guided treatment of HF reduces all-cause mortality and HF admissions in patients with HF.Study selectionEight databases, no language restrictions, up to November 2017 were searched for all randomised controlled trials comparing NP-guided treatment versus clinical assessment alone in adult patients with HF. No language restrictions were applied. Publications were independently double screened and extracted. Fixed-effect meta-analyses were conducted.Findings89 papers were included, reporting 19 trials (4554 participants), average ages 62–80 years. Pooled risk ratio estimates for all-cause mortality (16 trials, 4063 participants) were 0.87, 95% CI 0.77 to 0.99 and 0.80, 95% CI 0.72 to 0.89 for HF admissions (11 trials, 2822 participants). Sensitivity analyses, restricted to low risk of bias, produced similar estimates, but were no longer statistically significant.ConclusionsConsidering all the evidence to date, the pooled effects suggest that NP-guided treatment is beneficial in reducing HF admissions and all-cause mortality. However, there is still insufficient high-quality evidence to make definitive recommendations on the use of NP-guided treatment in clinical practice.Trial registration numberSystematic Review Cochrane Database Number: CD008966.

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