Why the study?
ACS patients require close follow-up to maintain treatment adherence and reduce adverse events, and digital health interventions might improve outcomes compared with standard care.
Do digital health interventions reduce mortality and improve medication adherence in acute coronary syndrome patients compared to standard care?
Do digital health interventions reduce mortality and improve medication adherence in acute coronary syndrome patients compared to standard care?
Digital health interventions significantly reduce all-cause mortality, rehospitalization, and medication nonadherence in patients following acute coronary syndrome.
Supports adoption of digital health interventions post-ACS; confirms mortality benefit in meta-analysis of trials.
OBJECTIVE: Acute coronary syndrome patients should be closely followed-up to maintain optimal adherence to medical treatments and to reduce adverse events. Digital health interventions might provide improved outcomes for patient care by providing closer follow- up, compared to standard care. Thus, in this meta-analysis, we aimed to evaluate the effect of digital health interventions on follow-up in acute coronary syndrome patients. METHODS: We searched medical databases to obtain all relevant studies comparing digital health interventions with standard care in acute coronary syndrome patients. After reviewing all eligible studies, a meta-analysis was conducted with the remaining 11 randomized controlled studies and 2 non-randomized controlled studies. A modified Jadad scale and Newcastle-Ottawa scale were used to assess the quality of the publications for randomized controlled studies and non-randomized controlled studies, respectively. RESULTS: This meta-analysis consisted of 7657 patients. The all-cause mortality rate was 49% lower in the digital health intervention cases, compared to those who received standard care [relative risk (RR) = 0.51 (0.37; 0.70), P <.01]. There was a significant decrease in systolic blood pressure in the digital health interventions group, compared to the standard care group [mean difference = -5.28 (-9.47; -1.08), P =.01]. The rate of nonadherence to anti-aggregant drugs was 69% lower in the digital health interventions than in the standard care group [RR = 0.31 (0.20; 0.46), P <.01]. Also, nonadherence rates for statin and beta-blockers were lower in the digital health interventions group. The risk of rehospitalization was observed to be 55% less in the digital health interventions patients, compared to the standard care group [RR = 0.45 (0.30; 0.67), P <.01]. CONCLUSION: Digital health interventions can be effective in follow-up for secondary prevention in acute coronary syndrome patients.
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Faysal Şaylık (2023) studied this question.
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