Browsing by Subject "intervention study"

Various cardiovascular diseases cause a significant portion of the direct healthcare costs. For this reason it is important to develop effective treatment strategies. In the treatment of heart failure maintaining healthy lifestyle is an important issue in addition to medical treatment. The aim of this study is to find out whether multidisciplinary interventions in the treatment of heart failure have had better patient outcomes and/or cost savings compared to the standard care and has a certain intervention method proved itself to be more effective than another. The study focuses on the published material in the last ten years, which is compared with prior systematic review about the same topic. The study was conducted as a systematic review. The literature search was performed on Medline (Ovid), CINAHL and Scopus databases. MeSH-terms and other keywords were used in the search. Search was limited to English-language studies. The article selection was made after 06.01.2004 published studies based on the inclusion and exclusion criteria. A quality assessment was made to the selected articles. Only valid articles exceeding 60 % of the maximum points were selected to this review. Literature search found 848 references, of which quality assessment was carried out for 17 articles. 12 articles were selected to this review. Based on statistical significance mortality rate was reduced only rarely. There were lots of heterogeneity in the results for reducing hospitalizations or improving the quality of life. Hospital or clinic-based interventions seemed to be slightly more effective than other intervention methods. There have been no major changes in the intervention methods, only the methods using mailed materials have been left out. Also the outcomes used are similar to those in the past, although validated instruments in different areas of determining the effectiveness have not been developed. This study found no clear evidence about the effectiveness of the treatment programs. Hospital or clinic-based interventions might be more effective than other intervention methods. There is a lot of research about the issue, but high-quality cost-effectiveness studies are lagging. The results from different studies are hard to integrate because the ways to measure vary. The effectiveness of the intervention depends on many factors, and the sheer increase in the knowledge does not seem to be crucial. For assessing the profitability of multidisciplinary interventions there is a need for a high-quality research about the cost-effectiveness of the treatment programs.