The MEDLINE, CINAHL, Embase, Clinical Trials, WHO, Registry of International Clinical Trials, and Central Cochrane were searched up to March 2022. The Consensus Health Economic Criteria instrument to assess risk-of-bias in economic evaluations, Cochrane risk-of-bias 2 for clinical trials, and an adaptation of Robins-I for quasi-experimental and cohort studies were employed. Results from nurse-led CM programs did not reduce mortality (RR 0.78, 95% CI 0.53 to 1.15; participants = 1345; studies = 6; I2 = 47%). They decreased HF hospitalizations (HR 0.79, 95% CI 0.68 to 0.91; participants = 1989; studies = 8; I2 = 0%) and all-cause ones (HR 0.73, 95% CI 0.60 to 0.89; participants = 1012; studies = 5; I2 = 36%). QoL improved in medium-term follow-up (SMD 0.18, 95% CI 0.05 to 0.32; participants = 1228; studies = 8; I2 = 28%), and self-care was not statistically significant improved (SMD 0.66, 95% CI -0.84 to 2.17; participants = 450; studies = 3; I2 = 97%). A wide variety of costs ranging from USD 4975 to EUR 27,538 was observed. The intervention was cost-effective at ≤EUR 60,000/QALY.
Nurse-led CM reduces all-cause hospital admissions and HF hospitalizations but not all-cause mortality. QoL improved at medium-term follow-up. Such programs could be cost-effective in high-income countries.
MEDLINE,CINAHL,Embase,临床试验,WHO,国际临床试验注册,和中央Cochrane被搜索到2022年3月。共识健康经济标准工具,用于评估经济评估中的偏差风险,临床试验的Cochrane偏倚风险2,并采用Robins-I进行准实验和队列研究。护士主导的CM项目的结果并没有降低死亡率(RR0.78,95%CI0.53至1.15;参与者=1345;研究=6;I2=47%)。他们降低了HF住院率(HR0.79,95%CI0.68至0.91;参与者=1989;研究=8;I2=0%)和全因住院率(HR0.73,95%CI0.60至0.89;参与者=1012;研究=5;I2=36%)。中期随访中QoL改善(SMD0.18,95%CI0.05至0.32;参与者=1228;研究=8;I2=28%),自我护理无统计学显著改善(SMD0.66,95%CI-0.84~2.17;参与者=450;研究=3;I2=97%).观察到各种费用,从4975美元到27,538欧元不等。干预措施的成本效益为≤60,000欧元/质量。
护士主导的CM降低了全因入院率和HF住院率,但不能降低全因死亡率。中期随访时QoL有所改善。此类方案在高收入国家可能具有成本效益。