Sumeet Gandhi1, Shu Chen2, Louisa Hong1, Kelly Sun1, Enying Gong2, Chaoyun Li2, Lijing L Yan3, Jon-David Schwalm4. 1. Department of Medicine (Division of Cardiology), Hamilton Health Sciences, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada. 2. Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China. 3. Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China. Electronic address: lijing.yan@duke.edu. 4. Department of Medicine (Division of Cardiology), Hamilton Health Sciences, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada. Electronic address: schwalj@mcmaster.ca.
Abstract
BACKGROUND: Despite the strong uptake of mobile health (mhealth) technology targeted at cardiovascular care, it is still unclear if this improves adherence to therapy and patient-related outcomes in those with established cardiovascular disease. METHODS: A systematic search of English and Chinese language studies was conducted to investigate the benefit of mhealth technology for the secondary prevention of cardiovascular disease. RESULTS: Twenty-seven studies with 5165 patients were included in the systematic review. Patients in the mhealth group showed increased adherence to medical therapy (odds ratio [OR], 4.51; P < 0.00001), as well as increased adherence to pharmacologic and nonpharmacologic therapy (OR, 3.86; P < 0.00001). Patients in the mhealth group showed the ability to meet recommended blood pressure targets (OR, 2.80; P < 0.001) with a trend toward the ability to meet exercise goals (OR, 2.55; P = 0.07), however, no significant difference in smoking cessation (OR, 1.42; P = 0.45) and the ability to meet lipid target levels (OR, 1.16; P = 0.29) was found. Patients in the mhealth group did not show a reduction in hospital readmission (OR, 0.93; P = 0.96), with a small number of studies showing a reduction in angina (OR, 0.23; P = 0.005), and a decrease in transient ischemic attack/stroke recurrence in those with cerebrovascular disease (OR, 0.18; P < 0.0001) and a trend toward lower observed mortality rate (OR, 0.19; P = 0.06). CONCLUSIONS: The mhealth group compared with the usual care group had increased adherence to medical therapy, ability to reach blood pressure targets, exercise goals, and showed less anxiety and increased awareness of diet and exercise. There was no difference in smoking cessation, ability to meet low-density lipoprotein cholesterol targets, and hospital readmission.
BACKGROUND: Despite the strong uptake of mobile health (mhealth) technology targeted at cardiovascular care, it is still unclear if this improves adherence to therapy and patient-related outcomes in those with established cardiovascular disease. METHODS: A systematic search of English and Chinese language studies was conducted to investigate the benefit of mhealth technology for the secondary prevention of cardiovascular disease. RESULTS: Twenty-seven studies with 5165 patients were included in the systematic review. Patients in the mhealth group showed increased adherence to medical therapy (odds ratio [OR], 4.51; P < 0.00001), as well as increased adherence to pharmacologic and nonpharmacologic therapy (OR, 3.86; P < 0.00001). Patients in the mhealth group showed the ability to meet recommended blood pressure targets (OR, 2.80; P < 0.001) with a trend toward the ability to meet exercise goals (OR, 2.55; P = 0.07), however, no significant difference in smoking cessation (OR, 1.42; P = 0.45) and the ability to meet lipid target levels (OR, 1.16; P = 0.29) was found. Patients in the mhealth group did not show a reduction in hospital readmission (OR, 0.93; P = 0.96), with a small number of studies showing a reduction in angina (OR, 0.23; P = 0.005), and a decrease in transient ischemic attack/stroke recurrence in those with cerebrovascular disease (OR, 0.18; P < 0.0001) and a trend toward lower observed mortality rate (OR, 0.19; P = 0.06). CONCLUSIONS: The mhealth group compared with the usual care group had increased adherence to medical therapy, ability to reach blood pressure targets, exercise goals, and showed less anxiety and increased awareness of diet and exercise. There was no difference in smoking cessation, ability to meet low-density lipoprotein cholesterol targets, and hospital readmission.
Authors: Niraj Varma; Iwona Cygankiewicz; Mintu P Turakhia; Hein Heidbuchel; Yu-Feng Hu; Lin Yee Chen; Jean-Philippe Couderc; Edmond M Cronin; Jerry D Estep; Lars Grieten; Deirdre A Lane; Reena Mehra; Alex Page; Rod Passman; Jonathan P Piccini; Ewa Piotrowicz; Ryszard Piotrowicz; Pyotr G Platonov; Antonio Luiz Ribeiro; Robert E Rich; Andrea M Russo; David Slotwiner; Jonathan S Steinberg; Emma Svennberg Journal: Circ Arrhythm Electrophysiol Date: 2021-02-12
Authors: Erin M Spaulding; Francoise A Marvel; Matthias A Lee; William E Yang; Ryan Demo; Jane Wang; Helen Xun; Lochan Shah; Daniel Weng; Oluwaseun E Fashanu; Jocelyn Carter; Julie Sheidy; Renee McLin; Jennifer Flowers; Maulik Majmudar; Eric Elgin; Valerie Vilarino; David Lumelsky; Vinayak Bhardwaj; William Padula; Jerilyn K Allen; Seth S Martin Journal: Circ Cardiovasc Qual Outcomes Date: 2019-05
Authors: Matthew M Symer; Jonathan S Abelson; Jeffrey Milsom; Bridget McClure; Heather L Yeo Journal: J Gastrointest Surg Date: 2017-07-06 Impact factor: 3.452
Authors: Eileen Bendig; Natalie Bauereiß; David Daniel Ebert; Frank Snoek; Gerhard Andersson; Harald Baumeister Journal: Dtsch Arztebl Int Date: 2018-11-05 Impact factor: 5.594
Authors: Lochan M Shah; Jie Ding; Erin M Spaulding; William E Yang; Matthias A Lee; Ryan Demo; Francoise A Marvel; Seth S Martin Journal: J Cardiovasc Transl Res Date: 2021-05-17 Impact factor: 3.216