Abstract
BackgroundCardiovascular disease (CVD) remains the leading cause of death worldwide. Mobile phones have become ubiquitous in most developed societies. Smartphone apps, telemonitoring, and clinician-driven SMS allow for novel opportunities and methods in managing chronic CVD, such as ischemic heart disease, heart failure, and hypertension, and in the conduct and support of cardiac rehabilitation.ObjectiveA systematic review was conducted using seven electronic databases, identifying all relevant randomized control trials (RCTs) featuring a mobile phone intervention (MPI) used in the management of chronic CVD. Outcomes assessed included mortality, hospitalizations, blood pressure (BP), and BMI.MethodsElectronic data searches were performed using seven databases from January 2000 to June 2019. Relevant articles were reviewed and analyzed. Meta-analysis was performed using standard techniques. The odds ratio (OR) was used as a summary statistic for dichotomous variables. A random effect model was used.ResultsA total of 26 RCTs including 6713 patients were identified and are described in this review, and 12 RCTs were included in the meta-analysis. In patients with heart failure, MPIs were associated with a significantly lower rate of hospitalizations (244/792, 30.8% vs 287/803, 35.7%; n=1595; OR 0.77, 95% CI 0.62 to 0.97; P=.03; I2=0%). In patients with hypertension, patients exposed to MPIs had a significantly lower systolic BP (mean difference 4.3 mm Hg; 95% CI −7.8 to −0.78 mm Hg; n=2023; P=.02).ConclusionsThe available data suggest that MPIs may have a role as a valuable adjunct in the management of chronic CVD.
Highlights
BackgroundCardiovascular disease (CVD) is the leading cause of death worldwide [1] and is a leading cause of hospital readmission
Traditional cardiac rehabilitation (CR) programs are the embodiment of these principles, offering support, tailored education, and supervised exercise [4]
A combination of search terms were used to maximize sensitivity: mobile applications, cell phones, smart phones, mobile phones, and text messaging were combined with cardiovascular disease, heart failure, ischemic heart disease, acute coronary syndrome, myocardial infarction, cardiac rehabilitation, and hypertension as either Medical Subject Headings (MeSH) terms or key words
Summary
BackgroundCardiovascular disease (CVD) is the leading cause of death worldwide [1] and is a leading cause of hospital readmission. Secondary prevention relies upon monitoring and control of modifiable risk factors such as hypertension, dyslipidemia, and obesity This is achieved through (1) patient education and empowerment, (2) the prescription of and compliance with optimal pharmacotherapy, (3) lifestyle modification, and (4) the early identification of clinical deterioration. Smartphone apps, telemonitoring, and clinician-driven SMS allow for novel opportunities and methods in managing chronic CVD, such as ischemic heart disease, heart failure, and hypertension, and in the conduct and support of cardiac rehabilitation. Objective: A systematic review was conducted using seven electronic databases, identifying all relevant randomized control trials (RCTs) featuring a mobile phone intervention (MPI) used in the management of chronic CVD.
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