Jonkman, Nini HWestland, HeleenGroenwold, Rolf H.HÂgren, SusannaAnguita, ManuelBlue, LyndaBruggink-André de la Porte, Pieta W.FDeWalt, Darren AHebert, Paul LHeisler, MicheleJaarsma, TinyKempen, Gertrudis I.J.MLeventhal, Marcia ELok, Dirk J.AMårtensson, JanMuñiz, JavierOtsu, HarukaPeters-Klimm, FrankRich, Michael WRiegel, BarbaraStrömberg, AnnaTsuyuki, Ross TTrappenburg, Jaap C.ASchuurmans, Marieke JHoes, Arno W2023-05-232023-05-232016-11-012018-07-31https://repository.upenn.edu/handle/20.500.14332/41626Background To identify those characteristics of self-management interventions in patients with heart failure (HF) that are effective in influencing health-related quality of life, mortality, and hospitalizations. Methods and Results Randomized trials on self-management interventions conducted between January 1985 and June 2013 were identified and individual patient data were requested for meta-analysis. Generalized mixed effects models and Cox proportional hazard models including frailty terms were used to assess the relation between characteristics of interventions and health-related outcomes. Twenty randomized trials (5624 patients) were included. Longer intervention duration reduced mortality risk (hazard ratio 0.99, 95% confidence interval [CI] 0.97–0.999 per month increase in duration), risk of HF-related hospitalization (hazard ratio 0.98, 95% CI 0.96–0.99), and HF-related hospitalization at 6 months (risk ratio 0.96, 95% CI 0.92–0.995). Although results were not consistent across outcomes, interventions comprising standardized training of interventionists, peer contact, log keeping, or goal-setting skills appeared less effective than interventions without these characteristics. Conclusion No specific program characteristics were consistently associated with better effects of self-management interventions, but longer duration seemed to improve the effect of self-management interventions on several outcomes. Future research using factorial trial designs and process evaluations is needed to understand the working mechanism of specific program characteristics of self-management interventions in HF patients.© 2016 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).heart failureindividual patient meta-analysisself-managementCardiologyCardiovascular DiseasesCirculatory and Respiratory PhysiologyMedical HumanitiesMedicine and Health SciencesNursingPreventive MedicineArticle