Authors: Holland R, Battersby J, Harvey I, Lenaghan E, Smith J and Hay L

Journal: Heart, 2005

Volume/pages: Vol 91, pp899-906

About the study

This systematic review explores the impact of multidisciplinary interventions for people with heart failure upon hospital admissions and mortality rates.   The authors included randomised controlled trials or RCTs of interventions that included a multidisciplinary team consisting of medical input plus a specialist nurse, pharmacist, dietician or social worker.   These interventions included home visits, home physiological monitoring, telephone follow up and clinic interventions.

Findings

The systematic review and meta-analysis included 30 trials, and demonstrated that, overall, multidisciplinary interventions for people with heart failure reduced hospital admission by up to 13% and mortality rates by up to 20%.   Home visit interventions had a significant impact on the reduction of all cause admission to hospital but not upon mortality rates, while telemonitoring and telephone follow-up were effective in reducing mortality but their impact upon hospital admission was not as strong.

Key Messages for practice

• Multidisciplinary interventions can reduce the likelihood of readmission to hospital and premature death for people with heart failure

• Home based interventions are an effective way of reducing hospital admissions for this group, and telephone interventions are an effective way of reducing numbers of deaths

• Findings of this study are not necessarily applicable to patients or service users with other conditions, or those who live in long term residential care.