Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 1, 2023
Date Accepted: Nov 24, 2023
Effectiveness and Feasibility of Telehealth-based Dietary Interventions Targeting Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Telehealth-based dietary interventions were recommended for cardiovascular disease (CVD) management during the COVID-19 pandemic; however, data regarding their effectiveness and feasibility are limited.
Objective:
To examine (1) the effectiveness of telehealth-based dietary interventions in improving clinical CVD risk factors and (2) their feasibility among CVD patients.
Methods:
To conduct this systematic review and meta-analysis of randomized controlled trials (RCTs), two investigators searched PubMed, Cochrane Library, Web of Science, and ClinicalTrials.gov databases based on predetermined search terms, and included English language RCTs published between January 2000 and July 2022. Pooled data for each CVD outcome were assessed using a random effects model. Mean difference (MD), standardized MD (SMD), or risk ratio (RR) were calculated using R software.
Results:
A total of 13 RCTs with 3,013 participants were included in the analysis. Participants had a mean age (SD) of 61.0 (standard deviation + 3.7) years, 18.3% were women. Approximately one-third of RCTs were conducted in the US (30.8%). Included studies used telephone, app, text, audio-visual media, or website-based interventions, and follow-up durations ranged from 4 to 56 weeks. Of the 13 included studies, 3 were of high quality, 9 were of moderate quality, and only 1 was of low quality. Pooled estimates showed systolic blood pressure (MD: -2.74 [95% CI: -4.93 to -0.56]) and low-density lipoprotein cholesterol (SMD: -0.11 [95% CI: -0.19 to -0.03]) to be significantly improved among CVD patients as a result of telehealth-based dietary interventions compared to usual care. There was no significant difference between the feasibility of telehealth-based dietary interventions versus usual care. Significant I2 indicated moderate to considerable heterogeneity.
Conclusions:
Conclusions:
Telehealth-based dietary interventions show promise in addressing CVD risk factors.
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