The perspective of people living with chronic heart failure on self-management interventions: a mixed-method overview for the COMPAR-EU project

Article type
Authors
Niño de Guzmán EP1, Pérez-Bracchiglione J2, Salas-Gama K3, Viteri-García A4, Alonso-Coello P1, Martinez-García L5
1Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB-Sant Pau)
2Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso
3Santa Creu i Sant Pau Hospital
4Cochrane Ecuador. Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE
5Iberoamerican Cochrane Centre
Abstract
Background: self-management interventions (SMIs) are complex interventions considered critical to achieve high-quality care for patients with chronic heart failure (CHF). Incorporating the perspective of people with CHF and their caregivers is essential for a successful implementation of SMIs.

Objectives: our primary objective is to identify, appraise and analyse the perspective of people living with CHF and their caregivers on SMIs. Specifically, we aim to:
1) explore how adults living with CHF value the importance of outcomes of SMIs, and;
2) identify contextual factors that impact acceptability and feasibility features from the perspective of people with CHF and their caregivers. This is one of four mixed-method overviews of the COMPAR-EU Project, a European Project aimed to identify and rank the most cost-effective SMIs for four chronic conditions (chronic obstructive pulmonary disease, CHF, obesity and type 2 diabetes mellitus).

Methods: we searched systematically for quantitative, qualitative and mixed-methods systematic reviews (SRs) through MEDLINE, CINAHL and PsycINFO up to November 2018. Two authors independently screened references for inclusion and sought additional records using forward citation of selected studies in Scopus, hand-searching references of previous overviews, and PubMed automatic search updates in MEDLINE until March 2019. In pairs, we conducted an assessment of quality using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist, and the estimation of overlap. We applied a convergent parallel synthesis approach with narrative and thematic synthesis of findings guided by the SMI taxonomy developed in the COMPAR-EU Project.

Results: we identified 1900 unique references and included 47 SRs (Fig.1). The SRs were published from 2007 to 2019 (Table 1). Most SRs were conducted in the UK (16/47, 34%) and the USA (13/47, 28%). Most SRs were qualitative evidence or mixed-methods synthesis (QES and MMS) (21 (45%) and 16 (34%), respectively). The more frequent methods used were: thematic synthesis (7/21, 33%) and meta-ethnography (6/21, 29%) in QES; the integrative approach (11/16, 69%) in MMS; and the narrative synthesis (8/10, 80%) for quantitative SRs. Overall, overlap of primary studies across reviews was less than 25%. We will present the results of the synthesis at the Colloquium.

Conclusions: we present an overview of quantitative and qualitative evidence of the perspective of patients with CHF and their caregivers on SMIs. These results will inform the SR research agenda in the SMI field and will be incorporated in the development of recommendations in the COMPAR-EU Project.

Patient or healthcare consumer involvement: this overview reflects the perspective of people living with CHF and their caregivers on SMIs and summarizes the body of evidence available in SRs. We will include feedback from other relevant stakeholders of the COMPAR-EU consortium.