Mobile Application-Based Interventions for People with Heart Failure: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiology
• Digital Health
• Health Services Research

Background:

• Mobile health (mHealth) applications show promise for improving heart failure (HF) management.
• Existing evidence on mHealth interventions for HF outcomes like mortality, hospitalization, self-care, and quality of life is limited and inconclusive.

Purpose of the Study:

• To systematically review and meta-analyze the effectiveness of mHealth application-based interventions in patients with heart failure.
• To assess the impact of these interventions on mortality, hospitalization rates, self-care, and quality of life.

Main Methods:

• A comprehensive literature search was performed across six major databases up to October 21, 2023.
• Data extraction and risk of bias assessment were conducted independently by two authors, utilizing the Cochrane risk-of-bias tool.
• Meta-analysis was performed using Review Manager and R, with sensitivity, subgroup, and GRADE analyses to evaluate evidence certainty.

Main Results:

• The review included 24 studies with 2886 participants.
• mHealth interventions significantly reduced heart failure-related hospitalizations (RR=0.72) and improved quality of life (SMD=0.46).
• No significant effects were observed on all-cause mortality, cardiovascular mortality, all-cause hospitalization, or self-care.

Conclusions:

• mHealth application-based interventions demonstrate effectiveness in reducing heart failure-related hospitalizations and enhancing patient quality of life.
• While promising, more high-quality randomized controlled trials are necessary to solidify these findings and guide clinical practice.
• Nursing management can consider mHealth interventions for potential benefits in HF patient care, pending further robust evidence.