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Vol. 2 No. 2 (2025)

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Submitted
September 13, 2026
Published
December 31, 2025

Copyright (c) 2025 Wafaa Bakr

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Heart Failure and Housing Instability: Systematic Review of Nurse–Social Consultant Interventions to Reduce Readmissions

https://doi.org/10.64483/202522770
Wafaa Bakr
Egypt, Egypt

Corresponding Author(s) : Wafaa Bakr

gmforms2@gmail.com

Saudi Journal of Medicine and Public Health, Vol. 2 No. 2 (2025)

Abstract

Background: Heart failure (HF) is a major cause of hospitalizations and hospital readmissions in the United States; about 6.7 million adults experience HF. HF self-care is affected by housing instability, which is a critical social determinant of health and is linked to poor outcomes. While integrated models of nurse and social consultant interventions have some evidence, it is inconsistent, and interventions may reduce the risk of readmission. Methods: This systematic review was conducted using the PRISMA 2020 guidelines and searched databases including PubMed/MEDLINE, Embase, Scopus, Web of Science and Cochrane Library for the past 5 years. The screening and deduplication were done by two independent reviewers using Rayyan and disagreements were resolved by discussion or by a third reviewer. Studies included were adult (≥18 years old) HF patients, who were included if their studies examined housing instability and at least one readmission-related outcome. Data extraction was done with a standardised data form and risk of bias was assessed using the Cochrane RoB 2, ROBINS-I and the CASP tools. A narrative synthesis was planned due to expected heterogeneity. Results: Nine studies were analyzed, of which included one prospective cohort, two randomized controlled trials, five retrospective analyses and one qualitative study. For HIV/HF patients, housing instability was associated with a 13% increase in all cause readmission at 180 days and a 73% increase in risk of 6-month rehospitalization. Households who were homeless were generally younger, Black or Hispanic, and had numerous economic and social disadvantages. The interventions conducted by nurse-social consultants, especially those incorporating direct visits and linking to resources, seemed to be effective at decreasing readmissions, though the results were limited by study diversity and quality. Outcome: Housing instability is a risk factor that is modifiable for HF readmission. Integrated nurse–social consultant interventions hold promise and need powered trials, standardisation of housing measures and longer follow-up, as well as policy level interventions to promote health equity.

Keywords

Heart failure, housing instability, readmission, nurse-led interventions, social work, social determinants of health, transitional care
Bakr, W. (2025). Heart Failure and Housing Instability: Systematic Review of Nurse–Social Consultant Interventions to Reduce Readmissions. Saudi Journal of Medicine and Public Health, 2(2), 3852–3861. https://doi.org/10.64483/202522770
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