The efficacy of mobile health in alleviating risk factors related to the occurrence and development of coronary heart disease: A systematic review and meta‐analysis

Abstract

The association between the efficacy of mobile health and the occurrence and development of coronary heart disease (CHD) is still unclear. Mobile health can alleviate the risk factors for CHD. PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang, and VIP databases were searched from inception through May 28, 2020. Randomized controlled trials of the effect of mobile health in alleviating the risk factors of CHD's occurrence and development were included. Risks of bias were assessed by two independent reviewers by using the RevMan 5.3, GRADEpro, and RoB2.0 to generate findings. Meta‐analyses were performed to investigate the effects of mobile health on risk factors for CHD. Subgroup analyses were conducted. Sixteen randomized controlled trials, including 3898 patients with CHD, were included. Meta‐analysis results showed that mobile health can reduce BMI (mean difference [MD] = − 1.24, 95% CI = − 2.02 to − 0.45, p < .05), waist circumference (MD = − 4.40, 95% CI = − 4.72 to − 4.08, p < .00001), total cholesterol (TC) level (MD = − 0.43, 95% CI = − 0.64 to − 0.22, p < 0.00001), low‐density lipoprotein cholesterol (LDL‐C) level (MD = − 0.31, 95% CI = − 0.48 to − 0.15, p < .05), diastolic blood pressure (MD = − 2.01, 95% CI = − 3.40 to − 0.623, p < .05), and depression (MD = − 8.32, 95% CI = − 12.83 to − 3.81, p < .05) and increase high‐density lipoprotein cholesterol level (MD = 0.16, 95% CI = 0.01 to 0.32, p < .05) with statistically significant differences. The results of subgroup analyses indicated that the simple mobile health intervention has more remarkable advantages in reducing BMI, TC, LDL‐C, and systolic blood pressure than the complex mobile health intervention. Mobile health can alleviate the risk factors for CHD and has a certain effect on the prevention and recovery of CHD. Simple mobile health has a remarkable advantage. Limited by the quantity and quality of included studies, future research enrolling high‐quality studies should be taken to verify the above conclusions.

Effectiveness of mHealth Interventions in the Control of Lifestyle and Cardiovascular Risk Factors in Patients After a Coronary Event: Systematic Review and Meta-analysis

“…In this sense, it is worth highlighting that only a few RCTs have measured waist circumference despite the positive correlation between abdominal obesity and atherosclerosis. This finding is in accordance with the results of Akinosum et al [ 43 ] and Huang et al [ 44 ] who also did not observe improvements in BMI; however, a recent meta-analysis [ 46 ] did find a reduction in BMI and waist circumference although few RCTs were included in the analysis. Moreover, each trial used a different kind of digital intervention (telephone calls, remote monitoring with smartphones, SMS text messages, medication reminder apps, conference call sessions, emails, or web apps).…”

“…Regarding SBP and DBP, our results agree with those obtained in recent meta-analyses [ 43 - 45 ]. However, they do not coincide with other meta-analyses that obtained improvements in DBP only [ 46 ]. They also do not coincide with the meta-analysis published by Kavradim et al [ 47 ], who observed improvements in both SBP and DBP.…”

“…In contrast, Akinosun et al [ 43 ] found improvements in LDL, HDL, and total cholesterol levels but not in triglycerides. Xu et al [ 46 ] observed significant improvements only in HDL and total cholesterol, but not in LDL cholesterol, and Kavradim et al [ 47 ] found significant improvements in total cholesterol and triglycerides, but not in LDL and HDL cholesterol. The digital technology interventions analyzed were not based on the use of mobile phone apps, but rather on SMS text messages and web-based coaching.…”

Effect of Integrated Nursing Care Based on Medical Alliance Mode on the Prevention and Treatment of Complications and Self-Efficacy of Patients with Coronary Heart Disease after PCI

“…Their self-management behaviors are influenced by many factors. For example, a negative psychological state can reduce the self-efficacy of patients and gradually erode their belief in treatment [ 16 , 17 ], while a low cognitive level may mislead patients into believing that PCI is a radical cure for CHD and restores their original living habits, which is not conducive to maintaining their nursing compliance [ 18 ]. Since CHD is a chronic disease, patients still need to maintain a positive attitude towards prevention and treatment after PCI.…”

An integrated approach for very high cardiovascular risk patients. Intermediate results

“…В целом схожих результатов удалось добиться нескольким исследовательским группам, результаты этих 4 РКИ были объединены в метаанализе Xu Y, et al: в группах пациентов со стабильной ИБС, в т.ч. после чрескожного коронарного вмешательства, ТМ вмешательство приводит к снижению показателей ОХС и ХС-ЛНП по сравнению с исходными и таковыми в группах контроля [24]. Необходимо подчеркнуть, что результаты первых нескольких месяцев наблюдения в ТМ программах зачастую не соответствуют окончательным.…”