Abstract
Individuals living in rural areas are more likely to experience cardiovascular diseases (CVD) and have increased barriers to regular physical activity in comparison to those in urban areas. This systematic review aimed to understand the types and effects of home-based connected health technologies, used by individuals living in rural areas with CVD. The inclusion criteria included technology deployed at the participant’s home and could be an mHealth (smart device, fitness tracker or app) or telehealth intervention. Nine electronic databases were searched across the date range January 1990–June 2021. A total of 207 full texts were screened, of which five studies were included, consisting of 603 participants. Of the five studies, four used a telehealth intervention and one used a form of wearable technology. All interventions which used a form of telehealth found a reduction in overall healthcare utilisation, and one study found improvements in CVD risk factors. Acceptability of the technologies was mixed, in some studies barriers and challenges were cited. Based on the findings, there is great potential for implementing connected health technologies, but due to the low number of studies which met the inclusion criteria, further research is required within rural areas for those living with cardiovascular disease.
Highlights
Due to the low number of studies which met the inclusion criteria of the systematic review, it is clear there is a lack of research investigating the use of digital technology to enhance the health outcomes of individuals living with cardiovascular diseases (CVD) in rural areas
Individuals living in rural areas have increased barriers to attending healthcare settings and conducting physical activity
Wearable technology has been underutilised despite the potential benefits to increasing physical activity levels
Summary
The current systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [27]. The search was comprised of three areas: cardiovascular disease, home-based technology, and rural participants. The current systematic review is a narrative synthesis including quantitative, qualitative, and mixed method study designs. This method was selected due to the heterogeneity of study designs, outcome measures and technologies. The narrative synthesis aimed to develop a preliminary synthesis for the effects of the included studies and understand why specific findings were seen [28]. This analysis examined similarities and differences within the included studies of the current systematic review
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