Previously submitted to: JMIR Cardio (no longer under consideration since Jun 26, 2026)
Date Submitted: Dec 22, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Clinical Impact of Digital Health Education for Patients with Heart Failure: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Heart failure (HF) is a major global health issue, with high morbidity, death, and frequent hospital readmissions. Digital health education may improve clinical outcomes in HF, but the variability observed across studies has not yet been assessed through a systematic review and meta-analysis in this population.
Objective:
To examine the impact of digital health education interventions on all-cause mortality, hospital readmissions, and health-related quality of life (HRQoL) in adults with HF.
Methods:
A systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 standards. Randomized controlled trials (RCTs) published between January 2015 and June 2025 were identified using PubMed and manual searches. Studies including adults with HF who had received digital health education using mobile apps, web-based platforms, tele-education, or digital therapies were eligible for the research. Primary outcomes included all-cause mortality, hospital readmission, and HRQoL. Risk ratios (RR) and mean differences (MD) were aggregated using fixed- or random-effects models, depending on heterogeneity.
Results:
Twenty-six RCTs involving diverse international cohorts were included. Digital health education interventions significantly reduced all-cause mortality (RR = 0.80; 95% CI: 0.66–0.97; p = 0.02). Hospital readmission risk was also lower in intervention groups (RR = 0.88; 95% CI: 0.79–0.99; p = 0.03) compared to standard of care (SoC). HRQoL showed modest improvements overall (MD = 4.11; 95% CI: 0.98–7.25; p = 0.01), particularly reflected in improve Minnesota Living with Heart Failure Questionnaire scores and self-care behavior domains. Heterogeneity was moderate for mortality and high for HRQoL outcomes.
Conclusions:
Digital health education interventions offer clinically significant advantages for patients with HF, decreasing mortality and readmissions while enhancing selected HRQoL metrics. These findings support the integration of digital education into multidisciplinary HF care. Future study should concentrate on standardizing intervention components, testing for long-term viability, and determining cost-effectiveness.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.