Effectiveness of mobile health applications on clinical outcomes and health behaviors in patients with coronary heart disease: A systematic review and meta-analysis
{"title":"Effectiveness of mobile health applications on clinical outcomes and health behaviors in patients with coronary heart disease: A systematic review and meta-analysis","authors":"Yining Zhu, Yuhan Zhao, Ying Wu","doi":"10.1016/j.ijnss.2024.03.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Mobile health applications (apps) have gained significant popularity and widespread utilization among patients with coronary heart disease (CHD). The objective of this study is to evaluate the effects of mHealth apps on clinical outcomes and health behaviors in patients with CHD.</p></div><div><h3>Methods</h3><p>Databases were searched from inception until December 2023, including Cochrane Library, PubMed, EMBASE, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Service System (SinoMed), Wanfang Data, China Science and Technology Journal Database (VIP), for randomized controlled trials (RCTs) regarding the effectiveness of mHealth apps in patients with CHD. Two researchers conducted a comprehensive review of the literature, extracting relevant data and evaluating each study’s methodological quality separately. The meta-analysis was performed utilizing Review Manager v5.4 software.</p></div><div><h3>Results</h3><p>A total of 34 RCTs were included, with 5,319 participants. The findings demonstrated that using mHealth apps could decrease the incidence of major adverse cardiac events (<em>RR</em> = 0.68, <em>P</em> = 0.03), readmission rate (<em>RR</em> = 0.56, <em>P</em> < 0.001), total cholesterol (<em>WMD</em> = −0.19, <em>P</em> = 0.03), total triglycerides (<em>WMD</em> = −0.24, <em>P</em> < 0.001), waist circumference (<em>WMD</em> = −1.92, <em>P</em> = 0.01), Self-Rating Anxiety Scale score (<em>WMD</em> = −6.70, <em>P</em> < 0.001), and Self-Rating Depression Scale score (<em>WMD</em> = −7.87, <em>P</em> < 0.001). They can also increase the LVEF (<em>WMD</em> = 6.50, <em>P</em> < 0.001), VO<sub>2</sub> max (<em>WMD</em> = 1.89, <em>P</em> < 0.001), 6-min walk distance (6MWD) (<em>WMD</em> = 19.43, <em>P</em> = 0.004), Morisky Medication Adherence Scale-8 score (<em>WMD</em> = 0.96, <em>P</em> = 0.004), and medication adherence rate (<em>RR</em> = 1.24, <em>P</em> = 0.03). Nevertheless, there is no proof that mHealth apps can lower low-density lipoprote in cholesterol, blood pressure, BMI, or other indicator (<em>P</em> > 0.05).</p></div><div><h3>Conclusion</h3><p>Mobile health apps have the potential to lower the incidence of major adverse cardiac events (MACEs), readmission rates, and blood lipids in patients with CHD. They can also help enhance cardiac function, promote medication adherence, and alleviate symptoms of anxiety and depression. To further corroborate these results, larger-scale, multi-center RCTs with longer follow-up periods are needed.</p></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"11 2","pages":"Pages 258-275"},"PeriodicalIF":2.9000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352013224000292/pdfft?md5=d39befe228c8f083c6c3577019262919&pid=1-s2.0-S2352013224000292-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nursing Sciences","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352013224000292","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
Mobile health applications (apps) have gained significant popularity and widespread utilization among patients with coronary heart disease (CHD). The objective of this study is to evaluate the effects of mHealth apps on clinical outcomes and health behaviors in patients with CHD.
Methods
Databases were searched from inception until December 2023, including Cochrane Library, PubMed, EMBASE, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Service System (SinoMed), Wanfang Data, China Science and Technology Journal Database (VIP), for randomized controlled trials (RCTs) regarding the effectiveness of mHealth apps in patients with CHD. Two researchers conducted a comprehensive review of the literature, extracting relevant data and evaluating each study’s methodological quality separately. The meta-analysis was performed utilizing Review Manager v5.4 software.
Results
A total of 34 RCTs were included, with 5,319 participants. The findings demonstrated that using mHealth apps could decrease the incidence of major adverse cardiac events (RR = 0.68, P = 0.03), readmission rate (RR = 0.56, P < 0.001), total cholesterol (WMD = −0.19, P = 0.03), total triglycerides (WMD = −0.24, P < 0.001), waist circumference (WMD = −1.92, P = 0.01), Self-Rating Anxiety Scale score (WMD = −6.70, P < 0.001), and Self-Rating Depression Scale score (WMD = −7.87, P < 0.001). They can also increase the LVEF (WMD = 6.50, P < 0.001), VO2 max (WMD = 1.89, P < 0.001), 6-min walk distance (6MWD) (WMD = 19.43, P = 0.004), Morisky Medication Adherence Scale-8 score (WMD = 0.96, P = 0.004), and medication adherence rate (RR = 1.24, P = 0.03). Nevertheless, there is no proof that mHealth apps can lower low-density lipoprote in cholesterol, blood pressure, BMI, or other indicator (P > 0.05).
Conclusion
Mobile health apps have the potential to lower the incidence of major adverse cardiac events (MACEs), readmission rates, and blood lipids in patients with CHD. They can also help enhance cardiac function, promote medication adherence, and alleviate symptoms of anxiety and depression. To further corroborate these results, larger-scale, multi-center RCTs with longer follow-up periods are needed.
期刊介绍：
This journal aims to promote excellence in nursing and health care through the dissemination of the latest, evidence-based, peer-reviewed clinical information and original research, providing an international platform for exchanging knowledge, research findings and nursing practice experience. This journal covers a wide range of nursing topics such as advanced nursing practice, bio-psychosocial issues related to health, cultural perspectives, lifestyle change as a component of health promotion, chronic disease, including end-of-life care, family care giving. IJNSS publishes four issues per year in Jan/Apr/Jul/Oct. IJNSS intended readership includes practicing nurses in all spheres and at all levels who are committed to advancing practice and professional development on the basis of new knowledge and evidence; managers and senior members of the nursing; nurse educators and nursing students etc. IJNSS seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Contributions are welcomed from other health professions on issues that have a direct impact on nursing practice.
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