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The gap between policy and practice: a systematic review of patient-centred care interventions in chronic heart failure.

Kane PM, Murtagh FE, Ryan K, Mahon NG, McAdam B, McQuillan R, Ellis-Smith C, Tracey C, Howley C, Raleigh C, O'Gara G, Higginson IJ, Daveson BA - Heart Fail Rev (2015)

Bottom Line: While the strength of evidence is poor, PCC has been shown to reduce symptom burden, improve health-related quality of life, reduce readmission rates and enhance patient engagement for patients with CHF.There is a small but growing body of evidence, which demonstrates the benefits of a PCC approach to care for CHF patients.Research is needed to identify the key components of effective PCC interventions before being able to deliver on policy recommendations.

View Article: PubMed Central - PubMed

Affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, London, SE5 9PJ, UK. pauline.m.kane@kcl.ac.uk.

ABSTRACT
Patient-centred care (PCC) is recommended in policy documents for chronic heart failure (CHF) service provision, yet it lacks an agreed definition. A systematic review was conducted to identify PCC interventions in CHF and to describe the PCC domains and outcomes. Medline, Embase, CINAHL, PsycINFO, ASSIA, the Cochrane database, clinicaltrials.gov, key journals and citations were searched for original studies on patients with CHF staged II-IV using the New York Heart Association (NYHA) classification. Included interventions actively supported patients to play informed, active roles in decision-making about their goals of care. Search terms included 'patient-centred care', 'quality of life' and 'shared decision making'. Of 13,944 screened citations, 15 articles regarding 10 studies were included involving 2540 CHF patients. Three studies were randomised controlled trials, and seven were non-randomised studies. PCC interventions focused on collaborative goal setting between patients and healthcare professionals regarding immediate clinical choices and future care. Core domains included healthcare professional-patient collaboration, identification of patient preferences, patient-identified goals and patient motivation. While the strength of evidence is poor, PCC has been shown to reduce symptom burden, improve health-related quality of life, reduce readmission rates and enhance patient engagement for patients with CHF. There is a small but growing body of evidence, which demonstrates the benefits of a PCC approach to care for CHF patients. Research is needed to identify the key components of effective PCC interventions before being able to deliver on policy recommendations.

No MeSH data available.


Related in: MedlinePlus

PRISMA flow diagram of study selection. SDM shared decision-making, HCP healthcare professional
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Fig1: PRISMA flow diagram of study selection. SDM shared decision-making, HCP healthcare professional

Mentions: The search retrieved 13,944 papers and a reference scan yielded 5 additional papers, as shown in the PRISMA flow diagram (Fig. 1) [50]. Of 12,078 papers screened at title and abstract, 12,020 papers were excluded, leaving 58 papers for full-text review. Forty-three papers were excluded as they did not fulfil the inclusion criteria. Fifteen papers were included regarding 10 studies with 3 additional articles regarding 1 study [51–53] and 2 additional articles regarding another study [54, 55].Fig. 1


The gap between policy and practice: a systematic review of patient-centred care interventions in chronic heart failure.

Kane PM, Murtagh FE, Ryan K, Mahon NG, McAdam B, McQuillan R, Ellis-Smith C, Tracey C, Howley C, Raleigh C, O'Gara G, Higginson IJ, Daveson BA - Heart Fail Rev (2015)

PRISMA flow diagram of study selection. SDM shared decision-making, HCP healthcare professional
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608978&req=5

Fig1: PRISMA flow diagram of study selection. SDM shared decision-making, HCP healthcare professional
Mentions: The search retrieved 13,944 papers and a reference scan yielded 5 additional papers, as shown in the PRISMA flow diagram (Fig. 1) [50]. Of 12,078 papers screened at title and abstract, 12,020 papers were excluded, leaving 58 papers for full-text review. Forty-three papers were excluded as they did not fulfil the inclusion criteria. Fifteen papers were included regarding 10 studies with 3 additional articles regarding 1 study [51–53] and 2 additional articles regarding another study [54, 55].Fig. 1

Bottom Line: While the strength of evidence is poor, PCC has been shown to reduce symptom burden, improve health-related quality of life, reduce readmission rates and enhance patient engagement for patients with CHF.There is a small but growing body of evidence, which demonstrates the benefits of a PCC approach to care for CHF patients.Research is needed to identify the key components of effective PCC interventions before being able to deliver on policy recommendations.

View Article: PubMed Central - PubMed

Affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, London, SE5 9PJ, UK. pauline.m.kane@kcl.ac.uk.

ABSTRACT
Patient-centred care (PCC) is recommended in policy documents for chronic heart failure (CHF) service provision, yet it lacks an agreed definition. A systematic review was conducted to identify PCC interventions in CHF and to describe the PCC domains and outcomes. Medline, Embase, CINAHL, PsycINFO, ASSIA, the Cochrane database, clinicaltrials.gov, key journals and citations were searched for original studies on patients with CHF staged II-IV using the New York Heart Association (NYHA) classification. Included interventions actively supported patients to play informed, active roles in decision-making about their goals of care. Search terms included 'patient-centred care', 'quality of life' and 'shared decision making'. Of 13,944 screened citations, 15 articles regarding 10 studies were included involving 2540 CHF patients. Three studies were randomised controlled trials, and seven were non-randomised studies. PCC interventions focused on collaborative goal setting between patients and healthcare professionals regarding immediate clinical choices and future care. Core domains included healthcare professional-patient collaboration, identification of patient preferences, patient-identified goals and patient motivation. While the strength of evidence is poor, PCC has been shown to reduce symptom burden, improve health-related quality of life, reduce readmission rates and enhance patient engagement for patients with CHF. There is a small but growing body of evidence, which demonstrates the benefits of a PCC approach to care for CHF patients. Research is needed to identify the key components of effective PCC interventions before being able to deliver on policy recommendations.

No MeSH data available.


Related in: MedlinePlus