Digital health intervention in patients with recent hospitalization for acute heart failure: A systematic review and meta-analysis of randomized trials

Department

Internal Medicine

Document Type

Article

Publication Title

International Journal of Cardiology

Abstract

Aim: To examine the efficacy of digital health interventions (DHI) versus standard of care among patients with prior heart failure (HF) hospitalization.

Methods: An electronic search of MEDLINE, Cochrane, OVID, CINHAL and ERIC, databases was performed through August 2021 for randomized clinical trials that evaluated the outcomes with DHI among patients with HF. Data were pooled using the random-effects model. The primary outcome was all-cause mortality.

Results: 10 randomized trials were included in our analysis, with a total of 7204 patients and a weighted follow up duration of 15.6 months. Compared with the reference group, patients in the DHI group had lower all-cause mortality (8.5% vs. 10.2%, risk ratio-RR 0.80; 95% confidence interval-CI 0.66 to 0.96; P = 0.02), as well as lower cardiovascular mortality (7.3% vs. 9.6%, RR 0.76; 95% CI 0.62 to 0.94; P = 0.01). There was no significant difference in HF-related hospitalizations (23.4% vs. 26.2%, RR 0.82; 95% CI 0.66 to 1.02; P = 0.07) and all-cause hospitalizations (48.3% vs. 49.9%, RR 0.89; 95% CI 0.77 to 1.03; P = 0.11) in the DHI versus reference groups. Patients in the DHI group had fewer days lost due to HF-related hospitalizations (mean difference-MD: -1.77; 95% CI -3.06,-0.48, p = 0.01; I2 = 51), but similar days lost to all-cause hospitalizations (MD: -0.76; 95% CI -3.07,-1.55, p = 0.52; I2 = 69) compared with patients in the reference group.

Conclusion: Compared with usual care, DHI among patients with HF provided significant reduction of all-cause mortality and cardiovascular mortality and had fewer total days lost to HF hospitalizations. There were no differences in all-cause hospitalizations, and HF hospitalizations.

First Page

46

Last Page

53

DOI

10.1016/j.ijcard.2022.04.039

Volume

359

Publication Date

7-15-2022

Comments

See full list of authors at journal website.

PubMed ID

35436558

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