Result card

  • EFF3: How does Structured telephone support (STS) affect disease-specific symptoms and findings (severity, frequency) of adults with chronic heart failure, compared to standard care without Structured telephone support (STS)?
English

How does Structured telephone support (STS) affect disease-specific symptoms and findings (severity, frequency) of adults with chronic heart failure, compared to standard care without Structured telephone support (STS)?

Authors: Mirjana Huic, Pernilla Östlund, Romana Tandara Hacek, Jelena Barbaric, Marius Ciutan, Cristina Mototolea, Silvia Gabriela Scintee

Internal reviewers: J. Puñal, J. Gonzalez-Enriquez, H. Stürzlinger, A. Lo Scalzo, S. Maltoni

Acknowledgments: We would like to thank Ms Ana Utrobičić, MLIS, the Head of the Central Medical Library at the University of Split School of Medicine, Split, Croatia for development of systematic literature search strategy and performed search on standard medical and HTA databases.

The same methodology was used as described in section for the whole domain.

One SR {Inglis et al, 2011} with four RCTs reporting on this specific question (three overlapping with our SR {Ramachandran et al, 2007, Galbreath et al, 2004, Cleland et al, 2005} and one recently published full text RCT Angermann et al, 2012 { } were found to answer question ”How does Structured telephone support (STS) affect disease-specific symptoms and findings (severity, frequency) of adults with chronic heart failure, compared to standard care without Structured telephone support (STS)?”. )?”. Data on this outcome were conflicting.

In SR published by Inglis et al, 2011 { }, three RCTs (Angermann 2007 published only as Abstract; Ramachandran 2007, Galbreath 2004) out of four assessing it (Cleland et al 2004 in addition) showed a significant improvement in NYHA Functional Class. Ramachandran et al, 2007 { }, in RCT aimed to assess 6 months role of telephonic disease management programme in improving the quality-of-life (QOL) of patients with heart failure showed  that for every 20 patients in the intervention group, 14 patients improved by 1 functional class while in the control group this was observed in only 3 patients for every 20 treated. Significant improvement in functional capacity of patients was found in the intervention group compared with controls over a 6-month period, measured by the 6-minute walk test in the intervention group (from 202.2 [81.5] to 238.1 [100.9] metres, p<0.05) but not in the control group (193.8 [81.5] to 179.7 [112.0] metres). Galbreath et al, 2004 { } in RCT with aim to evaluate the effectiveness of telephonic disease management (DM) as a clinical and cost-containment strategy in both systolic and diastolic CHF over a longer time period (18 months) and with a larger and more heterogeneous sample than those of previous studies, reported a statistically significant improvements in NYHA class in intervention group (P=0.001), but 6-minute walk data from 217 patients in whom data were available at each visit showed no significant benefit from telephonic DM (P=0.08). Cleland et al, 2005 { } showed similar, not statisticaly different NYHA functional class after 8 months in the two groups. Angermann et al, 2012 { }, in published full text article, reported HR of 0.73 (0.53-1.00), statistically significant more favourable results regarding NYHA class (P=0.05), in Intervention group patients, after clinical evaluation at 6 months. No differences between groups were found regarding pump function, heart rate, and blood pressure.

Details could be found in Appendix 3 and 4.

Important
Partially
Huic M et al. Result Card EFF3 In: Huic M et al. Clinical Effectiveness In: Jefferson T, Cerbo M, Vicari N [eds.]. Structured telephone support (STS) for adult patients with chronic heart failure [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali ; 2015. [cited 16 June 2021]. Available from: http://corehta.info/ViewCover.aspx?id=305

References