Seven studies were included in the review: 5 RCTs and 2 non-RCTs.
All the trials had a Jadad score of 2 or less.
All except one study reported a beneficial effect of the intervention on the various outcomes measured.
In one RCT (n=97), the intervention group had fewer unplanned readmissions (36 versus 63) and less out-of-hospital deaths at 6 months after discharge. The 1-year follow-up also showed fewer unplanned readmissions, out-of-hospital deaths and days of hospitalisation.
In a second RCT, the patients in the intervention group had better compliance with their medication than the control group (93% versus 51%), and showed improvements in medication knowledge (p<0.001), oedema signs and exercise capacity.
In a third RCT, the intervention group had fewer hospital readmissions, better compliance, improved exercise capacity and enhanced knowledge of the drug therapy; there was no statistically significant effect on quality of life.
In a fourth RCT (number of participants unclear), the intervention group had fewer all-cause mortality and nonfatal heart failure events than the controls (4 versus 16).
In a fifth RCT, there was a significant reduction in hospital readmissions for heart failure in the intervention group compared with the control group over the first 12-month period (24% versus 59%), and a significantly longer time to readmission.
In a before-and-after study, patients had significantly lower hospitalisation rates, but beta-blocker usage and doses increased and the number of clinic visits significantly increased compared with the pre-enrolment period.
One study found no difference in the number of hospitalisations between the intervention and control groups at 3 and 6 months after discharge.