Canadian Journal of Cardiology
Systematic Review/Meta-analysis| Volume 33, ISSUE 2, P219-231, February 2017

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Effect of Mobile Health Interventions on the Secondary Prevention of Cardiovascular Disease: Systematic Review and Meta-analysis

Published:September 13, 2016DOI:



      Despite the strong uptake of mobile health (mhealth) technology targeted at cardiovascular care, it is still unclear if this improves adherence to therapy and patient-related outcomes in those with established cardiovascular disease.


      A systematic search of English and Chinese language studies was conducted to investigate the benefit of mhealth technology for the secondary prevention of cardiovascular disease.


      Twenty-seven studies with 5165 patients were included in the systematic review. Patients in the mhealth group showed increased adherence to medical therapy (odds ratio [OR], 4.51; P < 0.00001), as well as increased adherence to pharmacologic and nonpharmacologic therapy (OR, 3.86; P < 0.00001). Patients in the mhealth group showed the ability to meet recommended blood pressure targets (OR, 2.80; P < 0.001) with a trend toward the ability to meet exercise goals (OR, 2.55; P = 0.07), however, no significant difference in smoking cessation (OR, 1.42; P = 0.45) and the ability to meet lipid target levels (OR, 1.16; P = 0.29) was found. Patients in the mhealth group did not show a reduction in hospital readmission (OR, 0.93; P = 0.96), with a small number of studies showing a reduction in angina (OR, 0.23; P = 0.005), and a decrease in transient ischemic attack/stroke recurrence in those with cerebrovascular disease (OR, 0.18; P < 0.0001) and a trend toward lower observed mortality rate (OR, 0.19; P = 0.06).


      The mhealth group compared with the usual care group had increased adherence to medical therapy, ability to reach blood pressure targets, exercise goals, and showed less anxiety and increased awareness of diet and exercise. There was no difference in smoking cessation, ability to meet low-density lipoprotein cholesterol targets, and hospital readmission.



      En dépit de la forte intégration de la technologie en santé mobile (m-santé) orientée vers les soins cardiovasculaires, on ignore encore si elle améliore l’observance au traitement et les résultats cliniques des patients qui ont une maladie cardiovasculaire établie.


      Une revue systématique des études de langue anglaise et chinoise a été menée pour examiner les avantages de la technologie en m-santé sur la prévention secondaire des maladies cardiovasculaires.


      Vingt-sept études totalisant 5165 patients ont été incluses dans la revue systématique. Les patients du groupe de m-santé ont montré une amélioration de l’observance au traitement médical (ratio d’incidence approché [RIA], 4,51; P < 0,00001), ainsi qu’une amélioration de l’observance au traitement pharmacologique et non pharmacologique (RIA, 3,86; P < 0,00001). Les patients du groupe de m-santé ont montré la capacité à atteindre les valeurs cibles recommandées de la pression artérielle (RIA, 2,80; P < 0,001) et une tendance à la capacité à atteindre les objectifs de l’exercice physique (RIA, 2,55; P = 0,07). Toutefois, aucune différence significative dans l’abandon du tabac (RIA, 1,42; P = 0,45) et la capacité à atteindre les valeurs cibles des concentrations de lipides (RIA, 1,16; P = 0,29) n’a été observée. Les patients du groupe de m-santé n’ont pas montré de réduction de la réadmission à l’hôpital (RIA, 0,93; P = 0,96), et de rares études ont montré une réduction de l’angine (RIA, 0,23; P = 0,005), et une diminution de la récurrence de l’ischémie cérébrale transitoire et de l’accident vasculaire cérébral chez ceux ayant une maladie vasculaire cérébrale (RIA, 0,18; P < 0,0001) et une tendance à l’observation d’un taux de mortalité plus faible (RIA, 0,19; P = 0,06).


      Comparativement au groupe qui a reçu les soins usuels, le groupe de m-santé a montré une amélioration de l’observance au traitement médical, de la capacité à atteindre les valeurs cibles de la pression artérielle et les objectifs de l’exercice physique, et a également montré une anxiété moindre et une sensibilisation accrue à l’alimentation et à l’exercice physique. Aucune différence dans l’abandon du tabac, la capacité à atteindre les valeurs cibles du cholestérol à lipoprotéines de faible densité et la réadmission à l’hôpital n’a été notée.
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