Application of Digital Health Technologies in Cardiac Rehabilitation for Patients With Coronary Heart Disease:...

The high mortality and recurrence rates associated with coronary heart disease (CHD) impose substantial health care costs and economic burdens globally. Identifying effective interventions to improve patient outcomes is paramount. Digital health technologies (DHTs) offer novel solutions to overcome the challenge of low participation rates in traditional cardiac rehabilitation (CR).

This review aims to systematically map the scope of application, intervention objectives, and evaluation metrics of DHTs in CR for patients with CHD, thereby providing a structured evidence base for future research and practice.

This scoping review adheres to the Joanna Briggs Institute's methodology and is reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic search was conducted across 5 major databases, PubMed, Web of Science, Embase, Cochrane Library, and EBSCO, covering the period from inception to February 2026. Inclusion criteria were developed based on the participants, concept, and context framework. Studies focused on the application of various DHTs within CR settings for patients with CHD. Eligible literature comprised randomized controlled trials, quasi-randomized controlled trials, and longitudinal before-and-after studies published in peer-reviewed journals. Two researchers (XZ and ZL) independently conducted literature screening and data extraction. Findings were presented through a comprehensive narrative synthesis and evidence gap maps.

A total of 43 studies were included, predominantly randomized controlled trials (n=40). Findings revealed (1) diverse technological formats, categorized into 3 main types: digital health tools, real-time remote support, and asynchronous communication. Multitechnology combined interventions have become the mainstream model (36/43, 83.7%). (2) Intervention objectives were multifaceted, consolidating into 4 dimensions: motivation and guidance, knowledge and skills, monitoring and security, and social and group dynamics. (3) Evaluation metrics were multidimensional, encompassing clinical physiological indicators, health behaviors, patient-reported outcomes, service use rates, and technological feasibility. DHTs demonstrated positive effects in improving short-term physiological function and health behaviors; however, evidence remains insufficient regarding their impact on long-term clinical outcomes such as reducing adverse events.

The innovation of this scoping review lies in integrating highly heterogeneous evidence to reveal the field's evolution from isolated tools toward systematic, integrated solutions. Research confirms that DHTs effectively overcome temporal and spatial constraints, enhancing rehabilitation accessibility and engagement. They serve as crucial strategic tools for bridging geographical disparities in health care resources and advancing equity in cardiovascular health services. However, the evidence base remains limited, including insufficient long-term efficacy data and inadequate exploration of vulnerable populations such as older people and those with low digital literacy. Future research urgently requires large-scale, long-term follow-up clinical trials, alongside enhanced studies on adaptability for specific populations and considerations of health equity. This will propel digital CR toward greater scientific rigor, universal applicability, and precision.