Effectiveness of the Advanced Practice Nursing interventions in the patient with heart failure: A systematic review.

The review combined studies by narrative only, because the studies were too different to pool, so it cannot give a single estimate of benefit. Only four databases were searched and grey literature was not searched, so relevant unpublished or less visible studies may have been missed. Many studies were from the US and Australia, and advanced practice nursing roles and health systems differed, so results may not transfer to your setting. Some included studies were observational, not randomised, so other differences between patients could explain the results. The interventions bundled education, follow-up, referral and medication management, so the review cannot say which part mattered most. Quality of life was addressed by only three studies and measured differently across studies.

The authors declared no conflicts of interest.

Do not assume every advanced nurse-led heart failure programme will reduce readmissions, mortality, cost or improve quality of life. The evidence was mixed for cost and quality of life, and the studies varied widely in design and setting.