Effectiveness of Telehealth Care on Self-care Behaviours in Heart Failure Patients: Systematic Review and...

Heart failure (HF) is a chronic condition requiring ongoing management. Telehealth may improve HF outcomes. This review examines effects on complications, rehospitalizations, costs, and mortality. It aims to inform guidelines and policies. The objective is to evaluate and synthesize evidence about the effectiveness of telehealth interventions in improving self-care behaviours among HF patients.

A systematic review and meta-analysis of randomized controlled trials (RCTs) from PubMed, CINHAL, Web of Science, and manual search through Google Scholar from 2016 until March 2025. Continuous data were pooled using the standardized mean difference. ROB 2 criteria assessed bias risk, while JBI evaluated the evidence level. This review protocol has been registered in PROSPERO.

Ten studies were included, totaling 2,128 patients. A meta-analysis showed improved self-care behaviours across six studies using the European Self-care Scale. The Standardized Mean Difference was significant between intervention and usual care groups (SMD = 1.075, t = 3.637, p < 0.001; 95% CI [0.495, 1.655]). This indicated that interventions were associated with a very large effect size and almost certainly a clinically meaningful improvement in self-care behaviours compared to the control group. However, there was no difference in self-care behaviours across the Management, Maintenance, and Confidence subscales of the Self-care Heart Failure Index between groups.

This meta-analysis found that Telehealth care significantly improved self-care in HF patients across 6 studies, as measured by the European Self-care Measure. However, no differences were noted in four studies utilizing the heart failure index. Future studies should have larger sample sizes and longer follow-ups to evaluate telehealth care's effectiveness on self-care behaviours in HF patients. The findings of this review regarding telehealth interventions would empower nurses' ongoing health coaching and enhance the quality and accessibility of patient care.