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Meta-Analysis
. 2019 Jul 12;19(1):166.
doi: 10.1186/s12872-019-1149-5.

The effect of mobile applications for improving adherence in cardiac rehabilitation: a systematic review and meta-analysis

Linqi Xu  1 , Feng Li  1 , Changli Zhou  1 , Jinwei Li  1 , Chengcheng Hong  2 , Qian Tong  3
Affiliations
Meta-Analysis

The effect of mobile applications for improving adherence in cardiac rehabilitation: a systematic review and meta-analysis

Linqi Xu et al. BMC Cardiovasc Disord. .

Abstract

Background: Despite of the established effectiveness, the acceptance and adherence of cardiac rehabilitation (CR) remains sub-optimal. Mobile technologies are increasingly used in promoting CR without any firm evidence of their safety and efficacy. This systematic review and meta-analysis were aimed to assess the effect of mobile applications as an intervention for improving adherence to CR.

Methods: Relevant studies were searched in PubMed, the Cochrane Library, Embase and Web of Science from inception to 29th December 2018. Eligible studies were the ones which used mobile applications as a stand-alone intervention or as the primary component for the intervention directed at improving CR adherence, without any limitations on outpatient or home-based CR.

Results: Eight studies were eligible for the systematic review including four randomized controlled trials (RCTs) as well as four before-after studies of which only one had control group. Four RCTs and 185 patients in experimental group were included in meta-analysis, which had evaluated the effect of mobile health applications on CR completion and had reported that the adherence of patients using mobile applications was 1.4 times higher than the control group (RR = 1.38; CI 1.16 to 1.65; P = 0.0003). Moreover, we also found mixed results in exercise capacity, mental health and quality of life.

Conclusion: The use of mobile applications for improving the adherence of the CR might be effective. However, it appears to be in the initial stage of implementing mobile applications in CR and more research is essential to validate their effectiveness.

Keywords: Adherence; Cardiac rehabilitation (CR); Mobile application.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow Diagram of Search Results
Fig. 2
Fig. 2
Risk of Bias Assessment
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Fig. 3
CR Completion for Intervention Group Compared with Control Group
Fig. 4
Fig. 4
Forest plot for the change of VO2peak
See this image and copyright information in PMC

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