eHealth interventions significantly promoted physical activity (SMD 0.35; 95% CI 0.02-0.70; P=0.04) and exercise capacity after 6 months compared with usual care in patients with CAD.
Meta-Analysis (n=1,497)
Do eHealth-supported interventions improve physical activity, exercise capacity, and quality of life in patients with coronary artery disease in phase III cardiovascular rehabilitation compared to usual care?
eHealth interventions in phase III cardiovascular rehabilitation effectively improve physical activity, exercise capacity, quality of life, and systolic blood pressure in patients with coronary artery disease.
Standardized Mean Difference: 0.35 (95% CI 0.02–0.7)
p-value: p=0.04
AIMS: To provide a quantitative analysis of eHealth-supported interventions on health outcomes in cardiovascular rehabilitation (CR) maintenance (phase III) in patients with coronary artery disease (CAD) and to identify effective behavioural change techniques (BCTs). METHODS AND RESULTS: A systematic review was conducted (PubMed, CINAHL, MEDLINE, and Web of Science) to summarize and synthesize the effects of eHealth in phase III maintenance on health outcomes including physical activity (PA) and exercise capacity, quality of life (QoL), mental health, self-efficacy, clinical variables, and events/rehospitalization. A meta-analysis following the Cochrane Collaboration guidelines using Review Manager (RevMan5.4) was performed. Analyses were conducted differentiating between short-term (≤6 months) and medium/long-term effects (>6 months). Effective behavioural change techniques were defined based on the described intervention and coded according to the BCT handbook. Fourteen eligible studies (1497 patients) were included. eHealth significantly promoted PA (SMD = 0.35; 95%CI 0.02-0.70; P = 0.04) and exercise capacity after 6 months (SMD = 0.29; 95%CI 0.05-0.52; P = 0.02) compared with usual care. Quality of life was higher with eHealth compared with care as usual (SMD = 0.17; 95%CI 0.02-0.32; P = 0.02). Systolic blood pressure decreased after 6 months with eHealth compared with care as usual (SMD = -0.20; 95%CI -0.40-0.00; P = 0.046). There was substantial heterogeneity in the adapted BCTs and type of intervention. Mapping of BCTs revealed that self-monitoring of behaviour and/or goal setting as well as feedback on behaviour were most frequently included. CONCLUSION: eHealth in phase III CR is effective in stimulating PA and improving exercise capacity in patients with CAD while increasing QoL and decreasing systolic blood pressure. Currently, data of eHealth effects on morbidity, mortality, and clinical outcomes are scarce and should be investigated in future studies. REGISTRATION: PROSPERO: CRD42020203578.
Heimer et al. (Mon,) conducted a meta-analysis in Coronary artery disease (CAD) (n=1,497). eHealth-supported interventions vs. usual care was evaluated on Physical activity (PA) (SMD 0.35, 95% CI 0.02-0.70, p=0.04). eHealth interventions significantly promoted physical activity (SMD 0.35; 95% CI 0.02-0.70; P=0.04) and exercise capacity after 6 months compared with usual care in patients with CAD.
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