Abstract
Cardiovascular disease (CVD) is a leading global cause of death and morbidity and
prevention needs to be strengthened to tackle this. Mobile health (mHealth) might
present a novel and effective solution in CVD prevention, and interest in mHealth
has grown dramatically since the advent of the smartphone. In this review, we discuss
mHealth interventions that target multiple cardiovascular risk factors simultaneously
in the context of primary as well as secondary prevention. There is some evidence
that mHealth interventions improve a range of individual CVD risk factors, but a relative
paucity of evidence on mHealth interventions improving multiple CVD risk factors simultaneously.
The existing data suggest mHealth programs improve overall CVD risk, at least in the
short term. Interpretation of the evidence is difficult in the context of poor methodology
and mHealth modalities often being a part of large complex interventions. In this
review we identify a number of unanswered questions including: which mode of mHealth
(or combination of interventions) would be most effective, what is the durability
of intervention effects, and what degree of personalization and interactivity is required.
Résumé
La maladie cardiovasculaire (MCV) est une des principales causes de mortalité et de
morbidité dans le monde et il est urgent de mettre l’accent sur sa prévention pour
s’attaquer à ce problème. Les applications mobiles en santé pourraient constituer
une solution innovante et efficace pour la prévention de la MCV, et l’intérêt pour
ce type de technologie a connu un essor fulgurant depuis les premiers téléphones intelligents.
Dans cette revue, nous examinons les applications mobiles en santé qui ciblent simultanément
plusieurs facteurs de risque cardiovasculaire dans le contexte de la prévention tant
primaire que secondaire. Les données probantes dont on dispose indiquant que les interventions
utilisant des applications mobiles en santé ont pour effet d’améliorer plusieurs facteurs
de risque de MCV individuels sont relativement plus nombreuses que celles attestant
une amélioration simultanée des facteurs de risque de MCV multiples. Les données existantes
laissent croire que les programmes d’applications mobiles en santé diminuent le risque
de MCV global, du moins à court terme. L’interprétation des données probantes est
difficile dans le contexte d’une méthodologie inadéquate et du fait que les modalités
utilisant des applications mobiles en santé sont souvent intégrées à des interventions
complexes à grande échelle. Dans cette revue, nous recensons plusieurs questions encore
sans réponse, y compris les suivantes : quel serait le mode d’utilisation le plus
efficace des applications mobiles en santé (ou d’une combinaison d’interventions),
quelle est la durabilité des effets de l’intervention, et quel est le degré de personnalisation
et d’interactivité requis.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Canadian Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Media Centre. Cardiovascular Diseases (CVDs).(Available at:)http://www.who.int/mediacentre/factsheets/fs317/en/Date accessed: February 5, 2016
Australian Institute of Health and Welfare. Monitoring acute coronary syndrome using national hospital data: an information paper on trends and issues. Cat. no. CVD 57 2011. Canberra: AIHW, 2011.
- Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study.Lancet. 2004; 364: 937-952
- AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association.J Am Coll Cardiol. 2011; 58: 2432-2446
- The rise and fall of cardiac rehabilitation in the United Kingdom since 1998.J Public Health (Oxf). 2007; 29: 57-61
- Six-month survival benefits associated with clinical guideline recommendations in acute coronary syndromes.Heart. 2010; 96: 1201-1206
- EUROASPIRE IV: a European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries.Eur J Prev Cardiol. 2016; 23: 636-648
- Adherence to secondary prevention therapies in acute coronary syndrome.Med J Aust. 2014; 201: S106-S109
- mHealth: new horizons for health through mobile technologies: second global survey on eHealth. Vol 2016. World Health Organization, Geneva, Switzerland2011
- Report: global smartphone penetration to jump 25% in 2014.(Available at:)http://www.fiercewireless.com/wireless/report-global-smartphone-penetration-to-jump-25-2014-led-by-asia-pacificDate accessed: July 20, 2017
- Mobile health use in low- and high-income countries: an overview of the peer-reviewed literature.J R Soc Med. 2013; 106: 130-142
- Current science on consumer use of mobile health for cardiovascular disease prevention: a scientific statement from the American Heart Association.Circulation. 2015; 132: 1157-1213
- Current and future directions of cardiovascular risk prediction.Am J Cardiol. 2006; 97: 28A-32A
- Global Action Plan for the Prevention and Control of NCDs 2013-2020.(Available at:)http://www.who.int/nmh/events/ncd_action_plan/en/Date accessed: March 10, 2016
- Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.Bull World Health Organ. 2011; 89: 286-295
- Measuring the Information Society Report 2015.(Available at:)http://www.itu.int/en/ITU-D/Statistics/Documents/publications/misr2015/MISR2015-w5.pdfDate accessed: October 5, 2017
- The mobile revolution–using smartphone apps to prevent cardiovascular disease.Nat Rev Cardiol. 2015; 12: 350-360
- Trends and features of top 100 grossing health and fitness iPhone apps [abstract 1028.5].FASEB J. 2014; 28: 1028.5
- Older adults and technology use.(Available at:)http://www.pewinternet.org/2014/04/03/older-adults-and-technology-useDate accessed: June 2, 2017
- Mobile phone-based interventions for smoking cessation.Cochrane Database Syst Rev. 2016; 4CD006611
- A systematic review and meta-analysis of interventions for weight management using text messaging.J Hum Nutr Diet. 2015; 28: 1-15
- A mobile phone intervention increases physical activity in people with cardiovascular disease: results from the HEART randomized controlled trial.Eur J Prev Cardiol. 2015; 22: 701-709
- Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis.Diabet Med. 2011; 28: 455-463
- Effect of home blood pressure telemonitoring with self-care support on uncontrolled systolic hypertension in diabetics.Hypertension. 2012; 60: 51-57
- Mobile phone text messages to support treatment adherence in adults with high blood pressure (SMS-Text Adherence Support [StAR]): a single-blind, randomized trial.Circulation. 2016; 133: 592-600
- Mobile phone-based lifestyle intervention for reducing overall cardiovascular disease risk in Guangzhou, China: a pilot study.Int J Environ Res Public Health. 2015; 12: 15993-16004
- A digital health intervention to lower cardiovascular risk: a randomized clinical trial.JAMA Cardiol. 2016; 1: 601-606
- The effect of a smartphone-based coronary heart disease prevention (SBCHDP) programme on awareness and knowledge of CHD, stress, and cardiac-related lifestyle behaviours among the working population in Singapore: a pilot randomised controlled trial.Health Qual Life Outcomes. 2017; 15: 49
- Workplace digital health is associated with improved cardiovascular risk factors in a frequency-dependent fashion: a large prospective observational cohort study.PLoS One. 2016; 11e0152657
- Effect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease: a randomized clinical trial.JAMA. 2015; 314: 1255-1263
- Text message and internet support for coronary heart disease self-management: results from the Text4Heart randomized controlled trial.J Med Internet Res. 2015; 17e237
- Evaluation of a telemedicine service for the secondary prevention of coronary artery disease.J Cardiopulm Rehabil Prev. 2012; 32: 25-31
- Effects of interactive patient smartphone support app on drug adherence and lifestyle changes in myocardial infarction patients: a randomized study.Am Heart J. 2016; 178: 85-94
- Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial.Heart. 2014; 100: 1770-1779
- Digital health intervention during cardiac rehabilitation: a randomized controlled trial.Am Heart J. 2017; 188: 65-72
- Medication nonadherence is associated with a broad range of adverse outcomes in patients with coronary artery disease.Am Heart J. 2008; 155: 772-779
- Adherence to Long-term Therapies: Evidence for Action.(Available at:)http://www.who.int/chp/knowledge/publications/adherence_report/en/Date accessed: October 2, 2017
- Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review.J Med Internet Res. 2015; 17: e52
- Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis.JAMA Intern Med. 2016; 176: 340-349
- Effect of mobile health interventions on the secondary prevention of cardiovascular disease: systematic review and meta-analysis.Can J Cardiol. 2017; 33: 219-231
Article info
Publication history
Published online: June 11, 2018
Accepted:
February 11,
2018
Received:
November 8,
2017
Footnotes
See page 912 for disclosure information.
Identification
Copyright
© 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Validation of Mobile Health Interventions in Cardiovascular Prevention: The Unanswered Questions in Light of LIGHTCanadian Journal of CardiologyVol. 34Issue 9
- PreviewWe read with interest the article entitled “Breaking Barriers: Mobile Health Interventions for Cardiovascular Disease” by Klimis et al.1 We want to thank the authors for their approach to mobile health (mHealth) technology that promises a greater opportunity for people to benefit from cardiovascular disease (CVD) prevention programmes.
- Full-Text
- Preview
