Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 18, 2024
Date Accepted: Apr 21, 2025
Impact of smartphone applications on reperfusion times and clinical outcomes in acute STEMI: a systematic review and meta-analysis
ABSTRACT
Background:
Mobile health applications are increasingly used by practitioners at the point of care in acute STEMI to improve coordination which may improve reperfusion times.
Objective:
We investigated the impact of app-based care strategies in acute STEMI.
Methods:
This is a systematic review of observational studies. We searched PubMed & Embase databases from 2008 to February 2024. Two reviewers independently performed the literature selection The primary outcome was the mean difference in reperfusion times. The secondary outcomes were short term mortality and false activation rates. For the primary outcome,
Results:
15 studies with 2113 patients were included in the meta-analysis. Door to balloon times were significantly lower in the group with mobile app-based care than in the control group (mean difference -19.73 minutes 95% CI -26.32 to -13.14 p < 0.01; I2 0.83). For the secondary outcome of short-term mortality, 6 studies with 814 patients were included in the meta- analysis. A modest reduction in short term mortality was associated with an app-based strategy versus usual care (Risk difference -0.05 95% CI -0.09 to -0.01 p = 0.02.)
Conclusions:
Mhealth app based care coordination in acute Stemi care pathways was associated with a significant reduction in door to balloon and a higher likelihood of meeting guideline directed time targets for reperfusion. Clinical Trial: PROSPERO registration: CRD42023481024 https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023481024
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