The impact of distance education on readmission of patients with heart failure: A systematic review and meta-analysis.
Sarina Ramtin, Zahra Yazdani, Kiarash Tanha and 1 others
PMID 36872565WHAT IT FOUND
Distance education interventions, which often included telemonitoring or nurse follow-up, were associated with fewer heart failure readmissions under 12 months, but not at 12 months or more.
Key findings
01In studies with less than 12 months follow-up, the pooled readmission risk ratio was 0.78 (95% CI 0.67 to 0.92).
02In studies with 12 months or more follow-up, the pooled readmission risk ratio was 0.89 (95% CI 0.73 to 1.09).
03For 12 months or more follow-up, the confidence interval included 1, so the pooled estimate did not show a significant reduction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only Persian and English studies were included, so relevant trials in other languages may be missing. Two included studies had poor risk of bias. The longer follow-up analysis had high heterogeneity, at 71.59%. Many interventions combined distance education with telemonitoring or other care, so the effect of education alone cannot be isolated. The significant reduction was only for follow-up under 12 months; the 12 months or more estimate did not show a significant reduction.
Declared interests
The study was supported by the Nursing & Midwifery Care Research Center, Tehran University of Medical Sciences (Grant number 47830). The authors declared no conflicts of interest, but one included study was the last author's own research.
The easy way to misread this
Do not conclude that distance education alone prevents heart failure readmission long term. The significant reduction was only in studies followed for less than 12 months, and the 12 months or more estimate had a confidence interval that included 1. Many trials also included telemonitoring or nurse follow-up, so the effect of education alone cannot be separated.