eHealth-supported Self-management and Telemonitoring in Heart Failure: A Systematic Review and Meta-analysis of...

The development of eHealth has offered a solution to the challenge of effective self-management for patients with heart failure (HF) by facilitating health information exchange, enabling frequent home monitoring, enhancing self-management and promoting patient empowerment. This study aimed to evaluate the effectiveness of eHealth interventions in improving self-management for patients with HF.

Systematic review and meta-analysis were performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines, by first selecting the relevant publications from the Cochrane Library, EBSCOhost, Epistemonikos, ProQuest, PubMed and Scopus as of 25 February 2025. The quality of the included studies was appraised using Cochrane Risk of Bias 2.0 tool. A meta-analysis of randomized controlled trials was performed using Review Manager software to estimate odds ratios (ORs) and standardized mean differences (SMDs).

We included 37 trials with 13,366 participants. eHealth reduced HF-related admissions (OR: 0.73 [95% confidence interval (CI): 0.62, 0.86; p=0.0002]). All-cause mortality did not differ (OR: 0.93 [95% CI: 0.85, 1.03; p=0.16]). Cardiovascular mortality was not reduced (OR: 0.85 [95% CI: 0.71, 1.01; p=0.07]). Quality of life showed borderline improvement on the Minnesota total score (mean difference: -7.25 [95% CI: -14.81, 0.31; p=0.06]; I²=91%). HF-related knowledge did not differ (SMD: 0.53 [95% CI: -0.12, 1.19; p=0.11]).

This meta-analysis demonstrates that incorporating eHealth interventions, particularly telemedicine, into standard HF care substantially decreases hospital admissions. While broader impacts on mortality, quality of life and knowledge remain inconclusive, the findings underscore the value of standardized eHealth integration as a pragmatic strategy to strengthen HF management and optimize patient outcomes.