Digital Health Interventions for the Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis

By R. Widmer, Nerissa M Collins, C. Collins, Colin P. West, L. Lerman, A. Lerman. Mayo Clinic proceedings, 2015

385 citations recorded by the source corpus.

Objective To assess the potential benefit of digital health interventions (DHI) on cardiovascular disease outcomes (CVD events, all-cause mortality, hospitalizations) and risk factors compared to non-DHI interventions. Patients and Methods We conducted a systematic search of PubMed, MEDLINE, EMBASE, Web of Science, OVID, CINHAL, ERIC, PsychInfo, Cochrane, and CENTRAL from January 1, 1990 and January 21, 2014. Included studies examined any element of DHI (telemedicine, web-based strategies, email, mobile phones, mobile applications, text messaging, and monitoring sensors) and CVD outcomes or risk factors. Two reviewers independently evaluated study quality utilizing a modified version of the Cochrane Collaboration risk assessment tool. Authors extracted CVD outcomes and risk factors for CVD such as weight, BMI, blood pressure, and lipids from 51 full-text articles that met validity and inclusion criteria. Results DHI significantly reduced CVD outcomes (RR=0.61, (95% CI, 0.45–0.83), P=.002; I2=22%). Concomitant reductions in weight (−3.35 lbs, (95% CI, −6.08 lbs, −1.01 lbs); P=.006; I2=96%) and BMI (−0.59 kg/m2, (95% CI, −1.15 kg/m2, −0.03 kg/m2); P=.04; I2=94%) but not blood pressure (+4.95 mmHg, (95% CI, −4.5 mmHg, 14.4 mmHg); P=.30; I2=100%) were found in these DHI trials compared to usual care. Framingham 10 year risk percentages were also significantly improved (−1.24%; 95% CI −1.73%, −0.76%; n=6; P<0.001; I2=94%). Results were limited by heterogeneity not fully explained by study population (primary or secondary prevention) or DHI modality. Conclusions Overall, these aggregations of data provide evidence that DHI can reduce CVD outcomes and have a positive impact on risk factors for CVD.

Subfields: Cardiology and Cardiovascular Medicine, General Health Professions, Public Health, Environmental and Occupational Health

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