Heart failure self-management: a scoping review of interventions implemented by allied health professionals

Background: Heart failure (HF) is typically managed using both medical and patient self-management interventions. Individuals with HF often have frequent readmissions to hospital for medical management. Effective self-management can help to reduce the exacerbation of HF symptoms and the frequency of readmissions. Methods: A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guidelines was conducted to identify literature on the interventions used by allied health professionals to promote HF self-management. A search strategy was implemented, and articles were reviewed by two independent reviewers. Results: Twenty articles met the inclusion criteria. Articles included interventions from physical therapy, nutrition, social work, and occupational therapy, as well as other health professions in team-based programs. The most common interventions were verbal education, textual information, monitoring resources, and skills practice. Interventions addressed diet/fluid control, exercise and activity, symptom monitoring, medication management, cardiovascular disease knowledge, and mental health. Many interventions were theory informed. Conclusion: There is nascent evidence that interventions promoting HF self-management positively impact health and quality of life outcomes. HF self-management is multi-faceted and requires interprofessional collaboration. Further work is warranted exploring the impact of theory-informed interventions, and the effectiveness of interventions on self-management competence and desired health outcomes. IMPLICATIONS FOR REHABILITATION Verbal education, printed information, monitoring documents/systems, and skills practice were the most common intervention modalities to promote heart failure self-management. Self-management interventions address diet/fluid control, exercise and activity, symptom monitoring, medication management, cardiovascular disease knowledge, and mental health aspects of heart failure. There is indicative evidence that interventions promoting heart failure self-management lead to increased health and quality of life outcomes. An interprofessional collaborative practice approach is important given that heart failure self-management is multi-faceted.