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Meta-Analysis
. 2024 Jun 7:13:596.
doi: 10.12688/f1000research.152315.1. eCollection 2024.

Digital health intervention in patients undergoing cardiac rehabilitation: systematic review and meta-analysis

Ali Suleiman Harbi  1 , Kim Lam Soh  1 , Putri Binti Yubbu  2 , Kim Geok Soh  3
Affiliations
Meta-Analysis

Digital health intervention in patients undergoing cardiac rehabilitation: systematic review and meta-analysis

Ali Suleiman Harbi et al. F1000Res. .

Abstract

Background: Cardiovascular disease (CVD) continues to be the foremost mortality internationally. Cardiac rehabilitation has proven as an effective program in reducing CVD burden. Participation in cardiac rehabilitation programs is very low. Digital health intervention emerged as an alternative method to deliver Cardiac rehabilitation. This review aimed to investigate the impact of digital health intervention on the outcomes of interest.

Methods: the following databases: PubMed, CINAHL, Scopus, and Cochrane Library have been searched to retrieve randomized controlled trials that examine the impact of digital health intervention on blood pressure, body mass index, lipid profile, blood glucose, Six-Minute Walk Test, and peak oxygen consumption. filters were set to include studies published in English between 2000-2023.

Results: Nineteen studies were included in this review. Six-Minute Walk Test (MD = 16.70; 95% CI: 6.00 to 27.39, p = 0.000) and maximal oxygen consumption (SMD = 0.27; 95% CI: 0.08 to 0.45, p = 0.004) significantly improved following digital health intervention, after employing the sensitivity analysis significant improvement was observed in systolic (MD = -2.54; 95% CI: -4.98 to -0.11, p = 0.04) and diastolic blood pressure (SMD = -2.0182; 95% CI: -3.9436 to -0.0928, p = 0.04) favoring experimental groups. Subgroup analysis revealed significant improvement in quality of life after three months of follow-up (SMD = 0.18; 95% CI: 0.05 to 0.31, p = 0.00), no significant differences have been observed in body mass index, lipid profile, and blood glucose.

Conclusion: The findings emphasize the significant impact of digital vs CBCR or usual care on physical capacity, blood pressure, and quality of life. Despite the non-statistically significant differences in body mass index and lipid profile, the comparable effect between the two methods suggests the superiority of digital over CBCR or usual care due to its convenient nature, accessibility, and cost-effectiveness.

Keywords: Digital; cardiac rehabilitation; mhealth; telerehabilitation; virtual; wearable devices.

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Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. PRISMA flow diagram of literature search process.
Figure 2.
Figure 2.. Risk of bias summary.
Figure 3.
Figure 3.. Risk of bias graph.
Figure 4.
Figure 4.. Forest plot of DHI vs CBCR/usual care impacts on SBP.
Figure 5.
Figure 5.. Forest plot of DHI vs CBCR/usual care impacts on DBP.
Figure 6.
Figure 6.. Forest plot of DHI vs CBCR/usual care impacts on TC.
Figure 7.
Figure 7.. Forest plot of DHI vs CBCR/usual care impacts on LDL.
Figure 8.
Figure 8.. Forest plot of DHI vs CBCR/usual care impacts on HDL.
Figure 9.
Figure 9.. Forest plot of DHI vs CBCR/usual care impacts on TG.
Figure 10.
Figure 10.. Forest plot of DHI vs CBCR/usual care impacts on BG.
Figure 11.
Figure 11.. Forest plot of DHI vs CBCR/usual care impacts on 6-MWT.
Figure 12.
Figure 12.. Forest plot of DHI vs CBCR/usual care impacts on VO2 peak.
Figure 13.
Figure 13.. Forest plot of DHI vs CBCR/usual care impacts on BMI.
Figure 14.
Figure 14.. Forest plot of DHI vs CBCR/usual care impacts on QoL.
Figure 15.
Figure 15.. Forest plot of subgroup analysis of DHI vs CBCR/usual care impacts on QoL (follow-up duration >3 months).
Figure 16.
Figure 16.. Forest plot of the subgroup analysis of DHI vs CBCR/usual care impacts on QoL (follow-up duration ≤ 3 months).
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