Preventing heart failure decompensation through digital tools: a systematic review and thematic synthesis of clinician views on mhealth apps post-pandemic

Abstract Introduction Heart failure (HF) demands effective preventive strategies, and mobile health (mHealth) apps are increasingly used to support monitoring and self-management. Clinician acceptance is essential for their successful integration, yet evidence on healthcare professionals’ experiences remains fragmented. Purpose To synthesise healthcare professionals’ perspectives on mobile health apps used in heart failure care through a qualitative systematic review and thematic synthesis. Methods Four databases (MEDLINE, Embase, CINAHL and PsycINFO) were systematically searched from 2020 onwards. A total of 651 records were screened. Eligible studies included healthcare professionals and reported qualitative findings on app-based monitoring or self-management tools. Data were extracted from the Results/Findings sections and synthesised using a thematic synthesis approach following Thomas and Harden. Preliminary descriptive themes are presented; full analytical synthesis is ongoing. Study quality was appraised using COREQ. The review is registered with PROSPERO. Results Eight studies were included. Preliminary synthesis identified five recurring themes: (1) concerns about data reliability, with clinicians reporting limited trust in patient-entered symptoms and biometric data; (2) workflow burden and alert overload, including excessive non-actionable notifications and parallel documentation processes; (3) lack of integration with HF pathways and EHR systems, reducing perceived clinical utility; (4) dependence on patient digital literacy, with older adults experiencing difficulty using and interpreting app functions; and (5) a central but overstretched role for HF nurses, who acted as primary digital triage points but reported increased workload pressures. Across studies, clinicians also highlighted several benefits, including improved patient engagement, earlier detection of deterioration, and enhanced continuity of care when digital tools functioned well. Study quality was overall moderate-to-high. Conclusion Clinicians recognise that mHealth apps hold meaningful preventive promise in HF care, yet adoption is constrained by concerns around data reliability, workflow disruption, and patient usability. Realising this potential will require seamless integration with existing HF pathways and EHR systems, alongside structured support for HF nurses who shoulder much of the digital workload.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.