February 7, 2018BMC Cardiovascular Disorders137 citationsOpen Access

Smartphones in the secondary prevention of cardiovascular disease: a systematic review

SHSandra J. Hamilton BMBelynda Mills EBEleanor M. Birch

Structured PICO

Does mHealth delivery improve outcomes and access in patients eligible for cardiac rehabilitation and heart failure management?

Population

Patients eligible for Cardiac Rehabilitation and Secondary Prevention (acute coronary syndrome, re-vascularisation procedures, controlled heart failure and other vascular or heart disease) or heart failure management. 9 studies included.

Intervention

Mobile health (mHealth) interventions utilizing smartphone functionality (either app or Wireless Application Protocol capabilities) for comprehensive Cardiac Rehabilitation and Secondary Prevention or heart failure rehabilitation.

Comparator

None, traditional cardiac rehabilitation, or usual care.

Outcome

Feasibility, utility, and uptake of mHealth; service outcomes (patient engagement, acceptance, adherence and completion, provider engagement and acceptance, and cost effectiveness); patient outcomes (clinical, exercise capacity, knowledge, social and emotional, QOL); health service utilisation.

Mobile health delivery is a feasible and effective alternative to traditional center-based cardiac rehabilitation, with potential to improve access for patients unable to attend in-person programs.

Abstract

BACKGROUND: Cardiac Rehabilitation (CR) and secondary prevention are effective components of evidence-based management for cardiac patients, resulting in improved clinical and behavioural outcomes. Mobile health (mHealth) is a rapidly growing health delivery method that has the potential to enhance CR and heart failure management. We undertook a systematic review to assess the evidence around mHealth interventions for CR and heart failure management for service and patient outcomes, cost effectiveness with a view to how mHealth could be utilized for rural, remote and Indigenous cardiac patients. METHODS: A comprehensive search of databases using key terms was conducted for the years 2000 to August 2016 to identify randomised and non-randomised trials utilizing smartphone functionality and a model of care that included CR and heart failure management. Included studies were assessed for quality and risk of bias and data extraction was undertaken by two independent reviewers. RESULTS: Nine studies described a mix of mHealth interventions for CR (5 studies) and heart failure (4 studies) in the following categories: feasibility, utility and uptake studies; and randomised controlled trials. Studies showed that mHealth delivery for CR and heart failure management is feasible with high rates of participant engagement, acceptance, usage, and adherence. Moreover, mHealth delivery of CR was as effective as traditional centre-based CR (TCR) with significant improvement in quality of life. Hospital utilization for heart failure patients showed inconsistent reductions. There was limited inclusion of rural participants. CONCLUSION: Mobile health delivery has the potential to improve access to CR and heart failure management for patients unable to attend TCR programs. Feasibility testing of culturally appropriate mHealth delivery for CR and heart failure management is required in rural and remote settings with subsequent implementation and evaluation into local health care services.

Perguntar à IA

Bookmark

View Full Paper