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. 2020 Jun 5:14:1179546820927402.
doi: 10.1177/1179546820927402. eCollection 2020.

Efficacy of Smartphone-Based Secondary Preventive Strategies in Coronary Artery Disease

Alexandra C Murphy  1   2 , Georgina Meehan  2 , Anoop N Koshy  1   2 , Phelia Kunniardy  2 , Omar Farouque  1   2 , Matias B Yudi  1   2
Affiliations

Efficacy of Smartphone-Based Secondary Preventive Strategies in Coronary Artery Disease

Alexandra C Murphy et al. Clin Med Insights Cardiol. .

Abstract

Background: Cardiac rehabilitation programs provide a comprehensive framework for the institution of secondary preventive measures. Smartphone technology can provide a platform for the delivery of such programs and is a promising alternative to hospital-based services. However, there is limited evidence to date supporting this approach. Accordingly, we performed a systematic review and meta-analysis examining smartphone-based secondary prevention programs to traditional cardiac rehabilitation in patients with established coronary artery disease to ascertain the feasibility and effectiveness of these interventions.

Methods: A systematic search of PubMed, MEDLINE, EMBASE, and the Cochrane Library was conducted. A meta-analysis was performed using a random-effects model with the outcomes of interest being 6-minute walk test (6MWT) distance, systolic blood pressure, low-density lipoprotein (LDL) cholesterol, and body mass index (BMI).

Results: A total of 8 studies with 1120 patients across 5 countries were included in the quantitative analysis. Follow-up ranged from 6 weeks to 12 months. Five studies examined all patients post acute coronary syndrome, 2 studies examined only patients undergoing percutaneous coronary intervention, and 1 study examined all patients with a diagnosis of coronary artery disease, independent of intervention. Exercise capacity, as measured by the 6MWT, was significantly greater in the smartphone group (20.10 meters, 95% confidence interval [CI] 7.44-33.97; P < .001; I 2 = 45.58). There was no significant difference in BMI reduction, systolic blood pressure, or LDL cholesterol levels between groups (P value for all > .05).

Conclusion: Publicly available smartphone-based cardiac rehabilitation programs are a convenient and easily disseminated intervention which show merit in exercise promotion in patients with established coronary artery disease. Further research is required to establish the clinical significance of recent findings favoring their use.

Keywords: cardiac rehabilitation; cardiovascular risk factors; mHealth; secondary prevention; smartphone.

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Conflict of interest statement

Declaration of Conflicting Interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram.
Figure 2.
Figure 2.
Meta-analysis of the primary endpoints.
See this image and copyright information in PMC

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