Background—Self-management interventions are widely implemented in care for patients with
heart failure (HF). Trials however show inconsistent results and whether specific patient groups
respond differently is unknown. This individual patient data meta-analysis assessed the
effectiveness of self-management interventions in HF patients and whether subgroups of patients
respond differently.
Methods and Results—Systematic literature search identified randomized trials of selfmanagement
interventions. Data of twenty studies, representing 5624 patients, were included and
analyzed using mixed effects models and Cox proportional-hazard models including interaction
terms. Self-management interventions reduced risk of time to the combined endpoint HF-related
all-0.71-
in Conclusions—This study shows that self-management interventions had a beneficial effect on
time to HF-related hospitalization or all-cause death, HF-related hospitalization alone, and
elicited a small increase in HF-related quality of life. The findings do not endorse limiting selfmanagement
interventions to subgroups of HF patients, but increased mortality in depressed patients warrants caution in applying self-management strategies in these patients.