Key result
mHealth-enabled disease management reduces all-cause readmissions ~32% and cardiac hospitalizations vs standard programs.
Why the study?
Integrating mHealth into disease management programs has potential to improve outcomes in CAD, but a more robust evaluation of the evidence was required.
Do mobile health-enabled disease management programs reduce readmissions and mortality in patients with coronary artery disease?
Meta-Analysis
Do mobile health-enabled disease management programs reduce readmissions and mortality in patients with coronary artery disease?
Effect estimate: RR 0.68 (95% CI 0.50-0.91)
Integrating mobile health technologies into disease management programs significantly reduces all-cause and cardiac-related readmissions in patients with coronary artery disease.
Supports mHealth integration into CAD disease management to cut readmissions; extends randomized evidence on secondary prevention.
Background: The use of mobile health (mHealth, wireless communication devices, and/or software technologies) in health care delivery has increased rapidly in recent years. Their integration into disease management programs (DMPs) has tremendous potential to improve outcomes for patients with coronary artery disease (CAD), yet a more robust evaluation of the evidence is required. Objectives: The purpose of this study was to undertake a systematic review and meta-analysis of mHealth-enabled DMPs to determine their effectiveness in reducing readmissions and mortality in patients with CAD. Methods: We systematically searched English language studies from January 1, 2007, to August 3, 2021, in multiple databases. Studies comparing mHealth-enabled DMPs with standard DMPs without mHealth were included if they had a minimum 30-day follow-up for at least one of all-cause or cardiovascular-related mortality, readmissions, or major adverse cardiovascular events. Results: Of the 3,411 references from our search, 155 full-text studies were assessed for eligibility, and data were extracted from 18 publications. Pooled findings for all-cause readmissions (10 studies, n = 1,514) and cardiac-related readmissions (9 studies, n = 1,009) indicated that mHealth-enabled DMPs reduced all-cause (RR: 0.68; 95% CI: 0.50-0.91) and cardiac-related hospitalizations (RR: 0.55; 95% CI: 0.44-0.68) and emergency department visits (RR: 0.37; 95% CI: 0.26-0.54) compared to DMPs without mHealth. There was no significant reduction for mortality outcomes (RR: 1.72; 95% CI: 0.64-4.64) or major adverse cardiovascular events (RR: 0.68; 95% CI: 0.40-1.15). Conclusions: DMPs integrated with mHealth should be considered an effective intervention for better outcomes in patients with CAD.
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Braver et al. (2023) conducted a meta-analysis in Coronary artery disease. mHealth-enabled disease management programs (DMPs) vs. Standard DMPs without mHealth was evaluated on All-cause readmissions (RR 0.68, 95% CI 0.50-0.91). mHealth-enabled disease management programs reduced all-cause readmissions (RR 0.68; 95% CI 0.50-0.91) and cardiac-related hospitalizations compared to standard programs without mHealth.
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