Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 31, 2023
Date Accepted: Mar 22, 2024
Effects of mobile health interventions on quality of life, anxiety, and depression in patients with coronary heart disease: A meta-analysis of randomized controlled trial
ABSTRACT
Background:
Coronary heart disease (CHD) is the leading cause of death globally. 20%-40% of CHD patients have co-morbid mental health issues such as anxiety and/or depression, affecting the prognosis and quality of life. Mobile health (mHealth) interventions have been developed and are widely used. However, the evidence for the effects of mHealth on quality of life, anxiety, and depression in CHD patients is currently ambiguous.
Objective:
To assess the effects of mobile health (mHealth) intervention on quality of life, anxiety, and depression in coronary heart disease (CHD) patients.
Methods:
We searched the Cochrane Library, PubMed, Embase, CINAHL, Web of Science, the China National Knowledge Infrastructure, and Wanfang databases from inception to August 12, 2023. Eligible studies were RCTs of patients with coronary heart disease (CHD), received mobile health (mHealth) interventions and reported on the outcomes of quality of life, anxiety, or depression. Utilizing the Cochrane "Risk of bias assessment tool," two researchers examined the abstracts, whole texts, extracted the data and assessed the risk of bias independently. Review Manager 5.4 and Stata 17.0 were used to conduct the meta-analysis. The effect size was calculated by the standardized mean difference and its 95% confidence interval.
Results:
The meta-analysis included 23 studies (5,406 participants) and showed that mHealth intervention could significantly improve the quality of life for CHD patients [SMD=0.46, 95% CI (0.23, 0.69), Z=3.85, P=0.0001], relieve their anxiety [SMD=-0.46, 95%CI (-0.84, -0.09), Z=2.43, P=0.02] and depression [SMD= -0.33, 95% CI (-0.55, -0.11), Z=2.94, P=0.003]. The subgroup analysis indicated that intervention duration ≥ 6 months showed better effects than < 6 months in relieve CHD patients’ anxiety and depression and the simple mHealth group (only one mHealth intervention was used.) is significantly more effective compared to the complex mHealth group (used two or more mHealth intervention methods) on quality of life, anxiety, and depression outcomes. Additionally, higher adherence rates (more than 90%) demonstrated improved effectiveness on anxiety and depression.
Conclusions:
Based on the existing evidence, mHealth intervention might be effective in improving the quality of life, reducing anxiety and depression in CHD patients. In the future, large-sample, high-quality, and rigorously designed RCTs are needed to provide further evidence. Clinical Trial: PROSPERO CRD42022383858; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=383858
Citation
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