Effectiveness of health education in the self-care and adherence of patients with heart failure: a meta-analysis.
Juliana de Melo Vellozo Pereira Tinoco, Lyvia da Silva Figueiredo, Paula Vanessa Peclat Flores and 3 others
PMID 34287537WHAT IT FOUND
In adults with heart failure, health education did not improve self-care scores in the main analysis, though a second analysis suggested benefit.
Adherence scores were higher in both analyses. Evidence was low.
Key findings
01Self-care did not differ between education and control groups in the fixed model, but was higher in the education group in the random model.
02Adherence was higher in the education group than in the control group, and this was significant in both models.
03For adherence, studies using home visits plus phone consultation were closest to favouring the education group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The evidence quality was low for both outcomes because of risk of bias, inconsistency and imprecision. Self-care results were inconsistent: the fixed model showed no difference, while the random model favoured education. Only studies with validated questionnaires and two groups were included, so other measures of adherence or self-care and more complex designs were not analysed. The included studies used different countries, designs, samples and educational strategies, and control groups usually received usual care. The review could not separate the contribution of individual components when interventions were combined, such as home visits plus phone consultation.
The easy way to misread this
Do not conclude that health education clearly improves self-care scores in heart failure. The fixed model was not significant, the random model was significant but the models did not converge, and GRADE rated the evidence low.