Effectiveness of mobile health applications on clinical outcomes and health behaviors in patients with coronary heart disease: A systematic review and meta-analysis.

OBJECTIVE: Mobile health applications (apps) have gained significant popularity and widespread utilization among patients with coronary heart disease (CHD). The objective of this study is to evaluate the effects of mHealth apps on clinical outcomes and health behaviors in patients with CHD.

METHODS: Databases were searched from inception until December 2023, including Cochrane Library, PubMed, EMBASE, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Service System (SinoMed), Wanfang Data, China Science and Technology Journal Database (VIP), for randomized controlled trials (RCTs) regarding the effectiveness of mHealth apps in patients with CHD. Two researchers conducted a comprehensive review of the literature, extracting relevant data and evaluating each study's methodological quality separately. The meta-analysis was performed utilizing Review Manager v5.4 software.

RESULTS: A total of 34 RCTs were included, with 5,319 participants. The findings demonstrated that using mHealth apps could decrease the incidence of major adverse cardiac events ( RR  = 0.68, P  = 0.03), readmission rate ( RR  = 0.56, P  < 0.001), total cholesterol ( WMD  = -0.19, P  = 0.03), total triglycerides ( WMD  = -0.24, P  < 0.001), waist circumference ( WMD  = -1.92, P  = 0.01), Self-Rating Anxiety Scale score ( WMD  = -6.70, P  < 0.001), and Self-Rating Depression Scale score ( WMD  = -7.87, P  < 0.001). They can also increase the LVEF ( WMD  = 6.50, P  < 0.001), VO2 max ( WMD  = 1.89, P  < 0.001), 6-min walk distance (6MWD) ( WMD  = 19.43, P  = 0.004), Morisky Medication Adherence Scale-8 score ( WMD  = 0.96, P  = 0.004), and medication adherence rate ( RR  = 1.24, P  = 0.03). Nevertheless, there is no proof that mHealth apps can lower low-density lipoprote in cholesterol, blood pressure, BMI, or other indicator ( P  > 0.05).

CONCLUSION: Mobile health apps have the potential to lower the incidence of major adverse cardiac events (MACEs), readmission rates, and blood lipids in patients with CHD. They can also help enhance cardiac function, promote medication adherence, and alleviate symptoms of anxiety and depression. To further corroborate these results, larger-scale, multi-center RCTs with longer follow-up periods are needed.