Outcomes of nurse-led telecoaching intervention for patients with heart failure: A systematic review and meta-analysis of randomised controlled trials

Abstract

Background: Studies have identified that nurse-led telephone health coaching benefited the continuity of care in patients with heart failure. However, the effect of nurse-led telephone health coaching remains inconclusive among the previous studies.

Aim: This review aimed to determine the effects of nurse-led telecoaching among patients with heart failure.

Design: This study was a systematic review and meta-analysis of randomised controlled trials. This study was reported in accordance with the PRISMA guideline.

Methods: Seven databases (PubMed, Embase, CINAHL, Web of Science, MEDLINE, Cochrane library and Ovid) were electronically searched up to 20 October 2020. The eligibility criteria were a randomised controlled trial study on heart failure patients, with the intervention led by a nurse through telephone coaching. Two authors independently evaluated the methodological quality using the modified Jadad scale. The Comprehensive Meta-Analysis software version 3.0 with a random effect model was used to conduct a meta-analysis, and Begg's and Egger's tests were performed to assess publication bias. Furthermore, sensitivity analysis was carried out.

Results: A total of 12 randomised controlled trials were met eligibility criteria and representing 1938 heart failure patients. The results showed that the nurse-led telecoaching significantly enhanced patients' self-care behaviour (SMD = .84, 95%CI [0.45-1.24], p < .001) and improved quality of life (SMD = .23, 95%CI [0.06-0.39], p = .007).

Conclusion: Nurse-led telecoaching appears to enhance self-care behaviour and improve quality of life in patients with heart failure. Further research needs to build the evidence for nurse-led telecoaching intervention, including understanding its mechanisms of action (e.g. frequency, components) and identifying its moderating factors.

Relevance to clinical practice: Implementation of nurse-led telecoaching is deemed helpful in promoting continuity of care because it was an accessible and sustainable intervention to improve patients' self-care and quality of life.

Keywords: heart failure; meta-analysis; nurse; quality of life; self-care; telenursing.