Effectiveness of telehealth interventions as a part of secondary prevention in coronary artery disease: a systematic review and meta‐analysis

Kavradım, Selma Turan; Özer, Zeynep; Boz, İlkay

doi:10.1111/scs.12785

Cited by 38 publications

(54 citation statements)

References 57 publications

(297 reference statements)

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“…Finally, regarding clinical conditions, CVD/events ( 41 , 52 , 59 , 62 , 80 – 82 , 92 , 93 , 95 , 96 ) and psychiatric disorders [depression ( 46 , 80 , 81 , 84 , 87 , 92 , 93 ) and anxiety ( 59 , 80 , 81 , 84 , 92 , 93 )] were the most common. Some outcomes, such as smoking cessation, were reviewed either as objective measures ( 94 ) or self-reported ( 39 , 79 , 80 , 83 , 93 – 97 , 105 ).…”

Section: Resultsmentioning

confidence: 99%

What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review

Castro

Ribeiro-Alves

Oliveira

et al. 2022

Front. Public Health

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Background: Lifestyle Medicine (LM) aims to address six main behavioral domains: diet/nutrition, substance use (SU), physical activity (PA), social relationships, stress management, and sleep. Digital Health Interventions (DHIs) have been used to improve these domains. However, there is no consensus on how to measure lifestyle and its intermediate outcomes aside from measuring each behavior separately. We aimed to describe (1) the most frequent lifestyle domains addressed by DHIs, (2) the most frequent outcomes used to measure lifestyle changes, and (3) the most frequent DHI delivery methods.Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) Extension for Scoping Reviews. A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Web of Science for publications since 2010. We included systematic reviews and meta-analyses of clinical trials using DHI to promote health, behavioral, or lifestyle change.Results: Overall, 954 records were identified, and 72 systematic reviews were included. Of those, 35 conducted meta-analyses, 58 addressed diet/nutrition, and 60 focused on PA. Only one systematic review evaluated all six lifestyle domains simultaneously; 1 systematic review evaluated five lifestyle domains; 5 systematic reviews evaluated 4 lifestyle domains; 14 systematic reviews evaluated 3 lifestyle domains; and the remaining 52 systematic reviews evaluated only one or two domains. The most frequently evaluated domains were diet/nutrition and PA. The most frequent DHI delivery methods were smartphone apps and websites.Discussion: The concept of lifestyle is still unclear and fragmented, making it hard to evaluate the complex interconnections of unhealthy behaviors, and their impact on health. Clarifying this concept, refining its operationalization, and defining the reporting guidelines should be considered as the current research priorities. DHIs have the potential to improve lifestyle at primary, secondary, and tertiary levels of prevention—but most of them are targeting clinical populations. Although important advances have been made to evaluate DHIs, some of their characteristics, such as the rate at which they become obsolete, will require innovative research designs to evaluate long-term outcomes in health.

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Section: Resultsmentioning

confidence: 99%

What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review

Castro

Ribeiro-Alves

Oliveira

et al. 2022

Front. Public Health

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“…This inconsistency might be explained by a previous systematic review of 24 studies comprising 6,773 participants with CAD that evaluated the effects of telehealth interventions on patient outcomes. The results showed small significant reductions in both SBP and DBP (Turan Kavradim, Özer, & Boz, 2020). Specifically, the baseline DBP in both the immediate intervention and waitlist control groups were below the home DBP threshold of 80 mmHg (Vongpatanasin et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Theory‐Based Health Information Technology Interventions on Coronary Artery Disease Self‐Management Behavior: A Clinical Randomized Waitlist‐Controlled Trial

Hong

Chen

Chang

et al. 2021

J of Nursing Scholarship

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Purpose Secondary prevention of coronary artery disease, self‐management behavior, and blood pressure control are important to cardiovascular event prevention and promotion of quality of life (QOL), but they are underutilized. The purpose of this study was to investigate the effects of a self‐efficacy theory–based health information technology intervention implemented through blood control and patient self‐management. Design A clinical randomized waitlist‐controlled trial. Methods The study was conducted at a medical center in Taipei, Taiwan. A total of 60 subjects were randomly assigned to either the immediate intervention (experimental) group or the waitlist control group. The primary endpoint was systolic blood pressure at 3 months; secondary end points included self‐management behavior and QOL. Treatment for the immediate intervention group lasted 3 months, while the waitlist control group received routine care for the first 3 months, at which point they crossed over to the intervention arm and received the same intervention as the experimental group for another 3 months. Both groups were evaluated by questionnaires and physiological measurements at both 3 and 6 months postadmission. The results were analyzed using generalized estimating equations. Results Systolic blood pressure significantly improved for the intervention group participants at 3 months, when there was also significant improvement in self‐management behavior and QOL. There was no significant or appreciable effect of time spent in the waitlist condition, with treatments in the two conditions being similarly effective. Conclusion The use of a theory‐based health information technology treatment compared with usual care resulted in a significant improvement in systolic blood pressure, self‐management behavior, and QOL in patients with coronary artery disease. Clinical Relevance This treatment would be a useful strategy for clinical care of cardiovascular disease patients, improving their disease self‐management. It also may help guide further digital health care strategies during the COVID‐19 pandemic.

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“…Another important consideration is whether interventions to improve implementation of medical management should be provided through in-person consultation or can be provided by remote means, such as telehealth. A recent systematic review 77) suggests that telehealth can be effective at improving secondary prevention in people with coronary artery disease.…”

Section: A Overall Recommendationsmentioning

confidence: 99%

Evidence-Based Recommendations for Medical Management of Peripheral Artery Disease

Golledge

Drovandi

2021

JAT

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Patients with lower limb artery stenosis or occlusion (peripheral artery disease; PAD) have been determined to be at very high risk of both major adverse cardiovascular events, such as myocardial infarction and stroke, and major adverse limb events, such as amputation and requirement for artery surgery. Effective medical management has been identified as key in reducing this risk; however, this is often poorly implemented in clinical practice. Thus, the aim of this narrative review was to summarize the current evidence on the medical management of PAD in order to inform clinicians and highlight recommendations for clinical practice. International guidelines, randomized controlled trials, and relevant systematic reviews and meta-analyses have been included in this study. The focus was the management of the key modifiable risk factors to mitigate possible adverse events through prescription of anti-platelet and anticoagulation drugs and medications to control low-density lipoprotein cholesterol, blood pressure, and diabetes and aid smoking cessation. The available evidence from randomized clinical trials provide a strong rationale for the need for holistic medical management programs that are effective in achieving uptake of these medical therapies in patients with PAD. In conclusion, people with PAD have some of the highest adverse event rates among those with cardiovascular diseases. Secondary preventive measures have been proven effective in reducing these adverse events; however, they remain to be adequately implemented. Thus, the need for an effective implementation program has emerged to reduce adverse events in this patient group.

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Effectiveness of telehealth interventions as a part of secondary prevention in coronary artery disease: a systematic review and meta‐analysis

Cited by 38 publications

References 57 publications

What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review

What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review

Effectiveness of Theory‐Based Health Information Technology Interventions on Coronary Artery Disease Self‐Management Behavior: A Clinical Randomized Waitlist‐Controlled Trial

Evidence-Based Recommendations for Medical Management of Peripheral Artery Disease

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