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"Help in a Heartbeat?": A Systematic Evaluation of Mobile Health Applications (Apps) for Coronary Heart Disease
Chiara Mack1, Yannik Terhorst2, Mirjam Stephan1
1Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University of Freiburg, 79085 Freiburg, Germany.
Insights
Mobile health applications (MHAs) can aid coronary heart disease (CHD) management, but quality reviews are lacking. This study found commercially available MHAs for CHD have average quality, often lacking evidence and robust engagement features.
Area of Science:
- Digital health
- Cardiovascular medicine
- Health informatics
Background:
- Lifestyle changes and disease management are crucial for coronary heart disease (CHD) patients.
- Mobile health applications (MHAs) offer potential to support CHD treatment.
- A significant gap exists in understanding the quality and functionality of available MHAs for CHD.
Purpose of the Study:
- To systematically assess the general characteristics, quality, and functions of MHAs designed for patients with CHD.
- To identify the prevalence of evidence-based information and engagement features in these applications.
Main Methods:
- Systematic search of Google Play and Apple App stores using a web crawler.
- Rating of MHA quality and characteristics using the Mobile Application Rating Scale (MARS) by two independent reviewers.
- Inclusion of 38 MHAs that met predefined criteria from an initial pool of 3078.
Main Results:
- Most MHAs (52.63%) were commercially affiliated and lacked a scientific evidence base.
- Average quality rating (M=3.38, SD=0.36) indicated deficiencies in information quality and user engagement.
- Common functions included information provision and risk score calculators; more features correlated with higher ratings.
Conclusions:
- Commercially available MHAs for CHD show potential but often lack documented clinical utility and evidence.
- Patients and healthcare providers face challenges in identifying high-quality, suitable MHAs.
- Development of curated databases for professionally reviewed MHAs is needed to guide selection.
Abstract:
For patients with coronary heart disease (CHD) lifestyle changes and disease management are key aspects of treatment that could be facilitated by mobile health applications (MHA). However, the quality and functions of MHA for CHD are largely unknown, since reviews are missing. Therefore, this study assessed the general characteristics, quality, and functions of MHA for CHD. Hereby, the Google Play and Apple App stores were systematically searched using a web crawler. The general characteristics and quality of MHA were rated with the Mobile Application Rating Scale (MARS) by two independent raters. From 3078 identified MHA, 38 met the pre-defined criteria and were included in the assessment. Most MHA were affiliated with commercial companies (52.63%) and lacked an evidence-base. An overall average quality of MHA (M = 3.38, SD = 0.36) was found with deficiencies in information quality and engagement. The most common functions were provision of information and CHD risk score calculators. Further functions included reminders (e.g., for medication or exercises), feedback, and health management support. Most MHA (81.58%) had one or two functions and MHA with more features had mostly higher MARS ratings. In summary, this review demonstrated that a number of potentially helpful MHA for patients with CHD are commercially available. However, there is a lack of scientific evidence documenting their usability and clinical potential. Since it is difficult for patients and healthcare providers to find suitable and high-quality MHA, databases with professionally reviewed MHA are required.
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