Nurse-led mobile health interventions for heart failure self-care: A systematic review

Heart failure places a heavy and growing demand on health systems, and much of its everyday management depends on what patients do at home: taking medicines as prescribed, weighing themselves, limiting salt and fluid, and noticing the early signs of decompensation. Nurses have traditionally led the education and follow-up that sustain these behaviours, and mobile health tools now allow that support to continue well beyond the clinic. This systematic review examined whether nurse-led mobile health interventions improve self-care and related outcomes in adults living with heart failure. Guided by PRISMA 2020, we searched PubMed/MEDLINE for studies published between January 2010 and October 2026 and supplemented this with citation and targeted keyword searching. Sixteen studies from fourteen countries were included, fifteen of them randomised. Interventions ranged from structured telephone support and messaging to smartphone applications, wireless telemonitoring and wearable-guided coaching. Most trials that used validated instruments reported better self-care, especially daily weighing, self-care maintenance and medication adherence, although some gains faded once active support ended. Effects on rehospitalisation were inconsistent; reductions appeared mainly where nurses acted promptly on transmitted data. Quality of life improved in several, but not all, trials. Small samples, short follow-up and the impossibility of blinding limit certainty. Nurse-led mobile health appears to strengthen heart failure self-care when technology is paired with timely clinical response, and it warrants rigorous testing in low- and middle-income settings, including India.