Effectiveness of web- and app-based health management interventions for patients at high risk of stroke: A systematic review and meta-analysis

This study aimed to systematically review randomized controlled trials evaluating the effectiveness of web- and app-based health management interventions for patients at high risk of stroke, including those with cardiovascular disease, type 2 diabetes, or obesity. Clinical outcomes (blood pressure and glycated hemoglobin), self-management knowledge, health behaviors, and quality of life were examined.

Following PRISMA guidelines, we searched PubMed, Web of Science, CINAHL, and the Cochrane Library for randomized controlled trials published between January 2010 and December 2024. Search terms included combinations of "Hypertension," "Diabetes Mellitus," "Myocardial Infarction," "Obesity," "Mobile Applications," and "Web-Based Intervention." Studies that provided sufficient data for quantitative synthesis were included in the meta-analysis. Pooled effect sizes were calculated using RevMan 5.4, and subgroup analyses were conducted based on intervention duration.

Thirty-five studies met the inclusion criteria. Meta-analysis revealed that web- and app-based interventions significantly improved blood pressure, glycated hemoglobin level, and medication adherence among individuals at high risk of stroke. These interventions also enhanced quality of life and increased self-management knowledge and behaviors. Subgroup analyses of web- or app-based educational programs indicated that clinical indicators improved with interventions lasting 3 months, whereas self-management knowledge, behaviors, and depression symptoms showed significant improvements with 6-month interventions.

This study demonstrates that web- and app-based health management interventions yield improvements in clinical, psychological, and behavioral outcomes for patients at high risk of stroke. These findings provide evidence for the development and implementation of tailored digital health interventions for effective stroke prevention and chronic disease management.