Spyros Kitsiou1, Haleh Vatani1, Guy Paré2, Ben S Gerber3, Susan W Buchholz4, Mayank M Kansal5, Jonathan Leigh6, Ruth M Masterson Creber7. 1. Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, Illinois, USA. 2. Research Chair in Diginal Health, HEC Montréal, Montréal, Quebec, Canada. 3. Division of Academic Internal Medicine and Geriatrics, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA. 4. Department of Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, Illinois, USA. 5. Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA. 6. Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, Illinois, USA; Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA. 7. Department of Population Health Sciences, Division of Health Informatics, Weill Cornell Medicine, New York, New York, USA.
Abstract
BACKGROUND: Heart failure (HF) is a complex and serious condition associated with substantial morbidity, mortality, and health care costs. We conducted a systematic review and meta-analysis to evaluate the effects of mobile health (mHealth) interventions compared with usual care in patients with HF. METHODS: We searched MEDLINE, CENTRAL, CINAHL, and EMBASE databases to identify eligible randomized controlled trials (RCTs) of mHealth interventions. Primary outcomes included: all-cause mortality, cardiovascular mortality, HF-related hospitalizations, and all-cause hospitalizations. Meta-analyses using a random effects model were performed for all outcomes. Risk of bias and quality of evidence were evaluated using the Cochrane Tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RESULTS: Sixteen RCTs involving 4389 patients were included. Compared with usual care, mHealth interventions reduced the risk of all-cause mortality (risk ratio [RR], 0.80; 95% confidence interval [CI], 0.65-0.97; absolute risk reduction [ARR], 2.1%; high-quality evidence), cardiovascular mortality (RR, 0.70; 95% CI, 0.53-0.91; ARR, 2.9%; high-quality evidence), and HF hospitalizations (RR, 0.77; 95% CI, 0.67-0.88; ARR, 5%; high-quality evidence), but had no effect on all-cause hospitalizations. Results were driven by mHealth interventions with remote monitoring and clinical feedback, which were associated with larger reductions than stand-alone mHealth interventions. However, subgroup differences were not statistically significant. CONCLUSIONS: mHealth interventions with remote monitoring and clinical feedback reduce mortality and HF-related hospitalizations, but might not reduce all-cause hospitalizations in patients with HF. Additional studies are needed to determine the efficacy of stand-alone mHealth interventions as well as active features of mHealth that contribute to efficacy.
BACKGROUND: Heart failure (HF) is a complex and serious condition associated with substantial morbidity, mortality, and health care costs. We conducted a systematic review and meta-analysis to evaluate the effects of mobile health (mHealth) interventions compared with usual care in patients with HF. METHODS: We searched MEDLINE, CENTRAL, CINAHL, and EMBASE databases to identify eligible randomized controlled trials (RCTs) of mHealth interventions. Primary outcomes included: all-cause mortality, cardiovascular mortality, HF-related hospitalizations, and all-cause hospitalizations. Meta-analyses using a random effects model were performed for all outcomes. Risk of bias and quality of evidence were evaluated using the Cochrane Tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RESULTS: Sixteen RCTs involving 4389 patients were included. Compared with usual care, mHealth interventions reduced the risk of all-cause mortality (risk ratio [RR], 0.80; 95% confidence interval [CI], 0.65-0.97; absolute risk reduction [ARR], 2.1%; high-quality evidence), cardiovascular mortality (RR, 0.70; 95% CI, 0.53-0.91; ARR, 2.9%; high-quality evidence), and HF hospitalizations (RR, 0.77; 95% CI, 0.67-0.88; ARR, 5%; high-quality evidence), but had no effect on all-cause hospitalizations. Results were driven by mHealth interventions with remote monitoring and clinical feedback, which were associated with larger reductions than stand-alone mHealth interventions. However, subgroup differences were not statistically significant. CONCLUSIONS: mHealth interventions with remote monitoring and clinical feedback reduce mortality and HF-related hospitalizations, but might not reduce all-cause hospitalizations in patients with HF. Additional studies are needed to determine the efficacy of stand-alone mHealth interventions as well as active features of mHealth that contribute to efficacy.
Authors: Sheikh Mohammed Shariful Islam; Rebecca Nourse; Riaz Uddin; Jonathan C Rawstorn; Ralph Maddison Journal: Front Cardiovasc Med Date: 2022-06-29
Authors: Spyros Kitsiou; Ben S Gerber; Mayank M Kansal; Susan W Buchholz; Jinsong Chen; Todd Ruppar; Jasmine Arrington; Ayomide Owoyemi; Jonathan Leigh; Susan J Pressler Journal: Contemp Clin Trials Date: 2021-05-13 Impact factor: 2.261
Authors: Guy Paré; Louis Raymond; Marie-Pascale Pomey; Geneviève Grégoire; Alexandre Castonguay; Antoine Grenier Ouimet Journal: Digit Health Date: 2022-07-21