Digital Health Interventions in Patient Management Following Acute Coronary Syndrome: A Meta-Analysis of the Literature

Abstract

Objective: Acute coronary syndrome patients should be closely followed-up to maintain optimal adherence to medical treatments and to reduce adverse events. Digital health interventions might provide improved outcomes for patient care by providing closer follow- up, compared to standard care. Thus, in this meta-analysis, we aimed to evaluate the effect of digital health interventions on follow-up in acute coronary syndrome patients. Methods: We searched medical databases to obtain all relevant studies comparing digital health interventions with standard care in acute coronary syndrome patients. After reviewing all eligible studies, a meta-analysis was conducted with the remaining 11 randomized controlled studies and 2 non-randomized controlled studies. A modified Jadad scale and Newcastle-Ottawa scale were used to assess the quality of the publications for randomized controlled studies and non-randomized controlled studies, respectively. Results: This meta-analysis consisted of 7657 patients. The all-cause mortality rate was 49% lower in the digital health intervention cases, compared to those who received standard care [relative risk (RR) = 0.51 (0.37; 0.70), P <.01]. There was a significant decrease in systolic blood pressure in the digital health interventions group, compared to the standard care group [mean difference = -5.28 (-9.47; -1.08), P =.01]. The rate of nonadherence to anti-aggregant drugs was 69% lower in the digital health interventions than in the standard care group [RR = 0.31 (0.20; 0.46), P <.01]. Also, nonadherence rates for statin and beta-blockers were lower in the digital health interventions group. The risk of rehospitalization was observed to be 55% less in the digital health interventions patients, compared to the standard care group [RR = 0.45 (0.30; 0.67), P <.01]. Conclusion: Digital health interventions can be effective in follow-up for secondary prevention in acute coronary syndrome patients.

Keywords

• acute coronary syndrome
• digital health intervention
• meta-analysis
• standard care