Key result
Telehealth cardiac rehabilitation programs significantly improved physical activity levels, exercise capacity, and medication adherence across 13 systematic reviews comprising 132 primary studies.
Why the study?
Existing systematic reviews on the health outcomes of telehealth cardiac rehabilitation in patients with coronary heart disease needed to be summarized.
Do telehealth cardiac rehabilitation programs improve health behaviors and modifiable risk factors in patients with coronary heart disease?
Systematic Review
Yes
Do telehealth cardiac rehabilitation programs improve health behaviors and modifiable risk factors in patients with coronary heart disease?
Telehealth cardiac rehabilitation programs are effective in improving health behaviors and modifiable CHD risk factors, particularly physical activity, without increasing adverse events.
Telehealth CR improves PA, depression, and QoL in CHD; extends support for routine integration while other outcomes need clarification.
PURPOSE: The aim of this study was to conduct an umbrella review summarizing the evidence from existing systematic reviews of telehealth cardiac rehabilitation (CR) on health outcomes of patients with coronary heart disease (CHD). REVIEW METHODS: An umbrella review of systematic reviews was undertaken in accordance with the PRISMA and JBI guidelines. A systematic search was conducted in Medline, APA PsycINFO, Embase, CINAHL, Web of Science, Cochrane database of systematic reviews, JBI evidence synthesis, Epistemonikos, and PROSPERO, searching for systematic reviews published from 1990 to current and was limited to the language source of English and Chinese. Outcomes of interest were health behaviors and modifiable CHD risk factors, psychosocial outcomes, and other secondary outcomes. Study quality was appraised using the JBI checklist for systematic reviews. A narrative analysis was conducted, and meta-analysis results were synthesized. SUMMARY: From 1301 identified reviews, 13 systematic reviews (10 meta-analyses) comprised 132 primary studies conducted in 28 countries. All the included reviews have high quality, with scores ranging 73-100%. Findings to the health outcomes remained inconclusive, except solid evidence was found in the significant improvement in physical activity (PA) levels and behaviors from telehealth interventions, exercise capacity from mobile health (m-health) only and web-based only interventions, and medication adherence from m-health interventions. Telehealth CR programs, work adjunct or in addition to traditional CR and standard care, are effective in improving health behaviors and modifiable CHD risk factors, particularly in PA. In addition, it does not increase the incidence in terms of mortality, adverse events, hospital readmission, and revascularization.
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Shi et al. (2023) conducted a systematic review in Coronary heart disease. Telehealth cardiac rehabilitation programs vs. Traditional cardiac rehabilitation and standard care was evaluated on Health behaviors, modifiable CHD risk factors, psychosocial outcomes, and other secondary outcomes. Telehealth cardiac rehabilitation programs significantly improved physical activity levels, exercise capacity, and medication adherence across 13 systematic reviews comprising 132 primary studies.
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