Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 12, 2022
Date Accepted: Sep 6, 2022
The Effectiveness of eHealth Self-Management Interventions in Patients with Heart Failure: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Heart failure (HF) is a common clinical syndrome with high morbidity, heavy burden of disease, and significant risk of readmission. eHealth self-management intervention may be an effective way to manage HF patients.
Objective:
This study aimed was to systematically review the evidence for the effectiveness of eHealth self-management in HF patients.
Methods:
We searched the EMBASE, PubMed, Cochrane Central Register of Controlled Trials and CINAHL from January 1, 2011 to April 23, 2021.The study included only randomised controlled trials (RCTs) that examined the effects of eHealth self-management interventions in HF patients. Meta-analysis was performed using Review Manager (RevMan v.5.4) and R (v.4.1.0 x64) software.
Results:
We included 22 RCTs which met our inclusion criteria. The meta-analysis suggested that eHealth interventions self-management significantly reduced all-cause mortality (OR 0.83, 95% CI 0.71 to 0.98, P = 0.02; low quality) and cardiovascular mortality (OR 0.74, 95% CI 0.59 to 0.92, p=0.008; moderate quality), as well as all-cause readmissions (OR 0.77, 95% CI 0.62 to 0.97, p=0.02; low quality) and HF-related readmissions (OR 0.78, 95% CI 0.66 to 0.91, p=0.002; moderate quality). eHealth self-management interventions increased patients’ knowledge of HF (SMD 0.35, 95% CI -0.10 to 0.81, p=0.13; low quality) and improved their quality of life (SMD 0.05, 95% CI -0.02 to 0.12, p=0.16; moderate quality), but there were no statistical differences. eHealth self-management interventions significantly increased medication adherence (OR 1.82, 95% CI 1.42 to 2.34, p<0.00001; low quality) and improved self-care behaviors (SMD -1.34, 95% CI -2.46 to -0.22, p=0.02; very low quality).
Conclusions:
The results show that eHealth self-management can support the health of patients with HF in a number of ways. However, the effectiveness of eHealth in self-management of patients with heart failure is affected by multiple aspects, and more clinical studies are needed to demonstrate its effectiveness. Clinical Trial: PROSPERO (CRD42021246973
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