Effectiveness of Interventions to Improve Heart Failure Self-care: An Umbrella Review of Systematic Reviews

Background: Heart failure (HF) is a global chronic condition that contributes to high hospitalization rates, mortality, and healthcare costs. Effective self-care is crucial for improving quality of life, reducing hospitalizations, and lowering costs. Although much research has examined strategies that improve physical activity adherence and interventions that reduce rehospitalization, no umbrella reviews have explicitly addressed interventions to improve self-care in chronic HF. Objective: The aim of this study was to systematically review existing evidence on interventions to improve self-care in adults with chronic HF. Methods: A comprehensive search for systematic reviews or meta-analyses published between 2011 and 2024 was conducted across 5 electronic databases. Two independent reviewers appraised the studies using the Joanna Briggs Institute tool. Quantitative findings were summarized by intervention type, sample size, and main outcomes, and then synthesized in tabular and narrative formats. Results: Forty-four systematic reviews met the inclusion criteria, encompassing 135 primary studies. The overlap across reviews was minimal (3.8%). The most prevalent categories of self-care intervention were face-to-face or telehealth education (63 studies), written educational materials (31 studies), and telemonitoring via phone calls or text messages (50 studies). The quality of the reviews ranged from moderate to high quality. The most effective interventions combined educational, psychological, and telehealth components. Conclusions: All intervention categories showed statistically significant improvements in HF self-care. Although the importance of self-care in HF management is recognized, the optimal delivery modality remains uncertain and multifaceted. Future research should focus on developing multimodal interventions based on behavioral change theories and evaluating their long-term impact.