In their recent systematic review and meta-analysis of the overall impact of multidisciplinary management programs on the risk of readmission and all-cause mortality in patients with chronic heart failure (CHF), Gwadry-Sridhar et al1 concluded that this type of intervention had a positive impact on morbidity but minimal impact on mortality. Our own meta-analysis of these same programs2 concluded that CHF management programs not only reduce the risk of readmission (risk ratio [RR], 0.84; 95% confidence interval [CI], 0.75-0.93) but also reduce the risk of all-cause mortality (RR, 0.83; 95% CI, 0.70-0.99). There are 2 important explanations why these analyses reached different conclusions.
Stewart S, McAlister FA, McMurray JJV. Heart Failure Management Programs Reduce Readmissions and Prolong Survival. Arch Intern Med. 2005;165(11):1311. doi:10.1001/archinte.165.11.1311-a