Technologies, such as smartwatches or smartphones, may improve behavioural and health outcomes among those living with cardiovascular disease

Akinosun AS, Polson R, Diaz-Skeete Y, et al. Digital technology interventions for risk factor modification in patients with cardiovascular disease: Systematic review and meta-analysis JMIR Mhealth Uhealth. 2021;9(3): e21061.

Review question

Are digital strategies effective in changing behaviours and reducing risk factors in people living with cardiovascular disease (CVD)?

Background

Lifestyle risk factors, such as diet, physical inactivity, smoking, and obesity account for approximately 50% of CVD cases. There are a growing number of digital strategies aiming to help people with and without chronic diseases improve their health and make behavioural changes. Although these strategies appear promising, summarized evidence on their effectiveness in changing behaviour and improving outcomes in individuals with CVD is lacking.

How the review was done

This is a systematic review and meta-analysis of 25 randomized controlled trials. The studies were published between 2002 and 2019 and included 5,799 participants.

Key features of the studies were:

• Participants had a diagnosis of CVD and were on average 60 years of age.
• Participants engaged in digital strategies—which combined the use of devices like cell/mobile phones, wearable technology, and laptops and desktops with technologies like the internet, apps, text messaging, and mobile sensors—alone or in addition to usual care. Examples of these strategies include phone or text-message support, telemonitoring, telerehabilitation, and online feedback and tracking.
• Researchers measured changes to behavioural outcomes (such as physical activity, diet, medication adherence, smoking, and alcohol consumption) and clinical outcomes (such as cholesterol, body mass index, blood sugar, and blood pressure).
• Results were compared to control groups who received usual care only.

What the researchers found

Compared to usual care, the review found that digital strategies may improve the following behavioural and health outcomes in people living with CVD: healthy eating, physical activity, medication adherence (in certain cases), sedentary behaviour, total cholesterol, LDL “bad” cholesterol, and lipoproteins (aka particles of fat + protein found in the blood). However, they do not seem to impact smoking, alcohol use, blood pressure, blood sugar, and body mass index.

Conclusion

Digital strategies may help improve some behavioural and health outcomes, potentially improving the lives of those living with CVD.