Background
Methods
Eligibility criteria
Patient | Adult patients (≥18 years) with CAD |
---|---|
Type of intervention and setting | e-Health secondary prevention programme alone or in addition to traditional secondary prevention care |
Comparison | Compared against the group that received traditional secondary prevention care |
Mode of e-Health delivery | m-Health; web-based technology; or a combination of m-Health and web-based technology |
Secondary prevention components | Physical activity and exercise management; Health education regarding medical; Psychosocial management; Self- monitoring; and Medical risk management |
Outcome | Adherence to treatment, modifiable CAD risk factors; psychosocial outcomes |
Design | Randomized controlled trials |
Exclusion criteria | Interventions in the form of telephone calls; Interventions evaluating heart monitoring systems. |
Search strategy
Study selection
Data extraction
Quality appraisal
Author (year) | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | SUM |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Norlund et al.2018 [26] | Y | Y | Y | NA | NA | U | U | Y | Y | Y | Y | Y | Y | 9 |
Thakkar et al. 2016 [27] | Y | Y | Y | NA | NA | U | U | Y | U | Y | Y | Y | Y | 8 |
Chow et al.2016 [28] | Y | Y | Y | NA | NA | Y | U | Y | Y | Y | Y | Y | Y | 10 |
Widmer et al. 2017 [29] | Y | U | Y | NA | NA | Y | U | Y | U | Y | Y | Y | Y | 9 |
Johnston et al. 2016 [30] | Y | U | Y | NA | NA | U | U | Y | U | Y | Y | Y | Y | 7 |
Wolf et al. 2016 [31] | U | U | Y | NA | NA | U | U | Y | U | Y | Y | Y | Y | 6 |
Fang et al. 2016 [32] | Y | U | Y | NA | NA | U | U | Y | U | Y | Y | Y | Y | 7 |
Pfaeffli Dale et al. 2015 [33] | Y | Y | Y | NA | NA | N | U | Y | Y | Y | Y | Y | Y | 9 |
Maddison et al. 2015 [34] | Y | U | Y | NA | NA | Y | U | Y | Y | Y | Y | Y | Y | 9 |
Frederix et al. 2015 [35] | Y | U | Y | NA | NA | Y | U | Y | Y | Y | Y | Y | Y | 9 |
Lear et al. 2015 [36] | U | U | Y | NA | NA | U | U | U | U | Y | Y | Y | Y | 5 |
Park et al. 2015 [37] | Y | Y | Y | NA | NA | U | U | Y | Y | Y | Y | Y | Y | 9 |
Park et al. 2014 [38] | Y | Y | Y | NA | NA | U | U | Y | Y | Y | Y | Y | Y | 9 |
Khonsari et al.2015 [39] | U | N | Y | NA | NA | U | U | Y | Y | Y | Y | Y | Y | 7 |
Frederix et al. 2015 [40] | Y | U | Y | NA | NA | U | U | Y | U | Y | Y | Y | Y | 7 |
Devi et al. 2014 [41] | Y | Y | Y | NA | NA | N | U | Y | Y | Y | Y | Y | Y | 9 |
Varnfield et al. 2014 [42] | Y | U | Y | NA | NA | U | U | Y | Y | Y | Y | Y | Y | 8 |
Vernooij et al. 2012 [43] | U | U | Y | NA | NA | U | U | Y | U | Y | Y | V | Y | 6 |
Blasco et al. 2012 [44] | Y | U | Y | NA | NA | U | U | Y | Y | Y | Y | Y | Y | 8 |
Reid et al. 2011 [45] | Y | Y | Y | NA | NA | U | U | Y | U | Y | Y | Y | Y | 8 |
Lindsay et al. 2009 [46] | U | U | U | NA | NA | U | U | U | U | Y | Y | U | Y | 3 |
Vieira et al. 2018 [47] | Y | U | U | NA | NA | U | U | Y | U | Y | Y | Y | Y | 6 |
Vieira et al. 2017 [48] | Y | U | U | NA | NA | U | U | Y | U | Y | Y | Y | Y | 6 |
Southard et al. 2003 [49] | Y | U | Y | NA | NA | U | U | Y | U | U | Y | Y | Y | 6 |
Describing and analysing studies
Results
Characteristics of included studies
Reference and country | Intervention arm | Control group | Sample size | Population | Mean age (SD) | Men (%) | Outcome measure | Measurement time points | Effects of the intervention | Intervention use |
---|---|---|---|---|---|---|---|---|---|---|
m-health | ||||||||||
Thakkar et al. 2016 [27] Australia. | Text messages in addition to traditional exercise based CR. | Traditional exercise based CR. | 710 (IG:352 CG: 358) | Patients with CAD. | 57.6 (9.18) | 81.9 | PO: Physical activity. | Baseline and after 6 months. | Effects on physical activity. | Seven patients requested the text messages to be stopped during follow-up. |
Chow et al. 2016 [28] Australia. | Text messages in addition to traditional exercise based CR. | Traditional exercise based CR. | 710 (IG:352 CG: 358) | Patients with CAD. | 57.6 (9.18) | 81.9 | PO: LDL-cholesterol level at 6 months. SO: Systolic blood pressure, heart rate, total cholesterol level, BMI, waist circumference, total physical activity, smoking status, proportion achieving guideline levels of modifiable risk factors, and adherence to medications. | Baseline and after 6 months. | Effects on LDL-cholesterol level, systolic blood pressure, BMI and smoking | Seven patients requested the text messages to be stopped during follow-up. |
Johnston et al. 2016 [30] Sweden. | An interactive web-based smartphone application and standard secondary prevention care | A simplified Web-based smartphone application and standard secondary prevention care. | 174 (IG:91 CG: 83) | Ticagrelor-treated MI patients. | 58 (8) | 81 | PO: Adherence to Ticagrelor, BMI, physical activity, smoking cessation, quality of life. SO: Patient medication use. Quality of life. Tools impact on CV risk factors, use of the tool over time, system usability and satisfaction, safety of the tool. | Evaluated at visit 2, 3 and after 6 months. | Effect on self-reported medication adherence in e-diary. | The proportion of patients who prematurely stopped using the e-diary was low and did not differed between the 2 study groups. |
Fang et al. 2016 [32] China. | A: Personalized text messages. B: Personalized text messages and a smartphone application. | Telephone call. | 280 (IGa:95;IGb:92 CG: 93) | Patients with chronic stable angina. | 53.6 | 71 | PO: Self-reported medication adherence. | Baseline and after 6 months. | No effect | |
Park et al. 2015 [37] USA. | A: Text messages for medication reminders and education. B: Text messages for education. | No text messages. | 90 (IGa:30 IGb:30 CG: 30) | Patients hospitalized for ACS. | 52.9 (9.4) | 75 | PO: Patient self-reported medication adherence, self-efficacy. SO: Social support, depression. | Baseline and after 30 days. | Effect in the percentage of prescribed number of dose taken, correct doses taken and doses taken on schedule. | |
Khonsari et al.2015 [39] Kuala Lumpur. | Text messages medication reminders. | Cardiac rehabilitation and follow-up appointments with cardiologist. | 62 (IG:31 CG: 31) | Patients with ACS. | 57.9 (12.64) | 85.5 | PO: The ratio of adherent patients to complete cardiac medication therapy. SO: Heart functional status (NYHA), ACS-related hospital readmission and death rates. | Baseline and after 8 weeks. | Effect in self-reported medication adherence, heart functional status. | 93.5% said the system was useful and 64.5% felt that it had helped them taking their medications. 80% requested for the SMS reminders to be continued. |
Park et al. 2014 [38] USA. | A: Text messages for medication reminders and education. B: Text messages for education. | No text messages. | 90 (IGa:30 IGb:30 CG: 30) | Patients hospitalized for ACS. | 52.9 (9.4) | 75 | PO: Medication adherence.SO: Feasibility and patient satisfaction. | Baseline and after 30 days. | Effect in the percentage of prescribed number of dose taken, correct doses taken and doses taken on schedule. | |
Blasco et al. 2012 [44] Spain. | m-health application including telemonitoring and text messages, lifestyle counseling and three clinical visits. | Three clinical visits and lifestyle counseling. | 203 (IG:102 CG: 101) | Patients with ACS. | 61 (11.5) | 83 | PO: Cardiovascular risk improvement. SO: Proportion of patients achieving treatment goals, quality of life, anxiety. | Baseline and after 12 months. | Effect in cardiovascular risk factors and treatment goals for blood pressure, BMI, and HbA1c. | Reasons for leaving the programme in the TMG were stress associated with the use of the telemonitoring equipment in 3 patients, personal reasons in 7, and inability to handle the equipment in 2 patients. |
Web-based technology | ||||||||||
Norlund et al. 2018 [26] Sweden. | Therapist-guided, tailored Web-based cognitive behavioural therapy. 10 modules with different themes, each containing 2 to 4 treatment steps. | Standard local healthcare. | 239 (IG:117 CG: 122) | Patients with a recent MI and symptoms of depression or anxiety. | 59.6 (8.49) | 67.5 | PO: Anxiety and depression. SO: Cardiac anxiety, depression and suicidal ideation. | Baseline and after 14 weeks. | No effect. | Treatment adherence was low. |
Vieira et al. 2018 [47] Portugal. | A: Virtual reality programme (Kinect) and education on cardiovascular risk factors. B: Paper booklet and education on cardiovascular risk factors. | Education on cardiovascular risk factors. | 46 (IGa:15; IGb:15, CG: 16) | Patients with CAD. | 66 | 100 | PO: Executive function. SO: Quality of life, depression, anxiety, stress. | Baseline and after 3 and 6 months. | Effects in executive function for IG1 (selective attention and conflict resolution ability). | The IG1: 82% participated in the first 3 months and 70% in the last three. The IG2: 90% participated in the first 3 months and 75% in the last 3 months. |
Vieira et al. 2017. Portugal. [48] | A: A virtual reality programme (Kinect) and education on cardiovascular risk factors. B: A paper booklet and education on cardiovascular risk factors. | Education on cardiovascular risk factors. | 46 (IGa:15; IGb:15, CG: 16) | Patients with CAD. | 66 | 100 | PO: Bioimpedancce, BMI, waist to hip circumference, and body composition. SO: Physical activity, eating habits, and lipid profile. | Baseline and after 3 and 6 months. | Effects in waist-to-hip ratio, ingestion of total fat and HDL cholesterol level. | The IG1: 82% participated in the first 3 months and 70% in the last three. The IG2: 90% participated in the first 3 months and 75% in the last 3 months. |
Lear et al. 2015 [36] Canada. | Virtual CR programme with on-line intake forms, scheduled chat sessions with nurse, exercise specialist and dietitian, education sessions, data capture for stress test and blood test results, monthly ask-an-expert group chat. | Simple guidelines for safe exercising and healthy eating, and a list of internet resources. | 78(IG:38 CG: 40) | Patients with CAD. | 60 | 85 | PO: Exercise capacity. SO: Lipid profile, blood glucose, Blood pressure, smoking status, BMI, waist circumference, physical activity, diet, hospital admission and emergency room visits. | Baseline and after 4 and 16 months. | Effect in Exercise capacity. | The median number of website logins per person was 27. 122 one-to -one private chat sessions. |
Devi et al. 2014 [41] England. | Web-based CR. Tailored goals on exercise, diet, emotions and smoking. Online exercise diary. Feedback on physical activity and smoking. Information on CAD-related risk factors. | Care from the GP and attending an annual check of risk factor management with a nurse. | 94 (IG:48 CG: 46) | Patients diagnosed with angina. | 66.27 (8.35) | 74 | PO: Daily average step count, SO: Energy expenditure, duration of sedentary activity, and duration of moderate activity. Weight, blood pressure and body fat percentage, fat and fiber intake, anxiety and depression, self-efficacy, quality of life. | Baseline, 6 weeks after randomization and then 6 months after the 6-week follow-up. | Effect in step-count, energy expenditure, self-efficacy, weight, emotional quality of life score and angina frequency. | The mean number of logins to the program was 18.68, an average of 3 logins per week per participant. Five patients felt trial was too burdensome. |
Vernooij et al. 2012 [43] Netherlands. | Internet-based risk factor management programme and usual care. | Physician at the hospital or general practitioner for risk factor management. | 330 (IG:164 CG: 166) | Patients with atherosclerosis in the coronary (49%), cerebral or peripheral arteries. | 59.9 (8.4) | 75 | PO: The relative change in Framingham heart risk score after 1 year. SO: The absolute changes in levels of risk factors, differences between groups in the change in proportion of patients reaching treatment goals for each risk factor. | Baseline and after 12 months. | No effect (a relative change of −12% in Framingham heart risk score). | 152 patients logged inn at a median of 56 times during the year. Patients (n = 134) sent a median 14 messages, and 131 patients entered a median 7 measurements. The monthly number of logins decreased during the intervention period. |
Reid et al. 2011 [45] England. | Physical-activity plan and access to a website for planning and tracking, and motivational feedback. | Attending a cardiologist and education booklet. | 223 (IG:115 CG: 108) | Patients with ACS. | 56.4 | 84.3 | PO: Physical activity: the average number of steps per day. SO: Self-reported leisure-time physical activity, heart disease health-related quality of life. | Baseline, and after 6 and 12 months. | Effects in physical activity, emotional and physical dimensions of quality of life. | 61.7% of participants completed at least three of the five tutorials. Thirty-seven participants emailed the exercise specialist at least once. |
Lindsay et al. 2009 [46] England. | Moderated web-based discussion groups. | Unmoderated online discussion group. | 108 (IG:54 CG: 54) | Patients with CAD. | 62.9 | 66 | PO: Changes in health behaviour. | Baseline and after 6 and 9 months. | Effects in self-reported diet during moderated phase. | Message writing to moderators decreased from the moderated to the unmoderated phase, while message writing between participants increased. |
Southard et al. 2003 [49] USA | Web-based interactive educational programme | Usual care. | 104 (IG: 53 CG: 51) | Patients with CAD. | 62.3 (10.6) | 75 | PO: Diastolic blood pressure, height, weight, LDL levels, exercise, diet, depression, economic evaluation. | Baseline and after 6 months. | Effect on weight loss and BMI, | On average, the individuals in the IG group logged on to the Web site 58 times over the course of the 6-month intervention, or approximately two times per week. |
Combination | ||||||||||
Widmer et al. 2017 [29] USA. | Web- and smartphone-based CR in addition to standard phase II CR. | A standard phase II CR. | 80 (IG:40 CG: 40) | Patients after PCI for ACS. | 62.5 (10.7) | 78 | PO: CV-related ED visits and readmissions. SO: Weight, blood pressure, heart rate, glucose/HbA1c, lipids, physical activity, diet, quality of life, mood, compliance. | Baseline and after 3 months. | Effect on weight reduction. | 16% continued to use the application after 3 months. |
Wolf et al. 2016 [31] Sweden | A: Person-centered care in addition to a Web- and mobile-based application. B: Person-centered care. | Usual care. | 199 (IGa:37; IGb: 57; CG: 105) | Patients with ACS. | 60 (10) | 75 | PO: Changes in general self-efficacy. SO: Return to work or prior activity level, rehospitalization or death 6 months after discharge. | Baseline and after 6 months. | Effect in general self-efficacy. | The majority used the mobile app rather than the web-based app as the primary source. Patients used the eHealth tool a mean of 38 times during the first 8 weeks and 64 times over a 6-month period. |
Pfaeffli Dale et al. 2015 [33] New Zealand. | Personalized text messages and web-page portal in addition to standard CR. | Standard CR. | 123 (IG:61 CG: 62) | Patients with CAD. | 59.5 (11.1) | 81 | PO: Adherence to recommended health guidelines, subsequent CAD risk probability. SO: Biomedical risk factors, self-reported medication adherence, self-efficacy, illness perception, anxiety and depression, serious adverse event data. | Baseline and after 3 and 6 months. | Effect on adherence to recommended health guidelines and self-reported medication adherence. | All but one in the IG received the Text4Heart programme. High fidelity to the text messaging component. 85% read all their text messages. 79% felt that 24-week programme was the right length. |
Maddison et al. 2015 [34] New Zealand. | Web-site and text messages in addition to community-based CR. | Community-based CR. | 171 (IG:85 CG: 86) | Patients diagnosed with CAD. | 60 (9.3) | 81 | PO: Change in PVO2. SO: Self-reported physical activity, self-efficacy and motivation to exercise, health related quality of life. Economic evaluation. | Baseline and after 24 weeks. | Effect in leisure time physical activity and walking, self-efficacy to be active and the general health domain of quality of life. | 82% of participants read some or all of the HEART text messages and 57% of participants viewed some or all of the video messages on the web-site. On average participants viewed the website once every 2 weeks. |
Frederix et al. 2015 [35] Belgium. | Tele-rehabilitation programme in addition to conventional CR. | Conventional CR. | 140 (IG:70 CG: 70) | Patients entered cardiac rehabilitation for CAD or heart failure. | 61 (9) | 81 | PO: VO2 peak. SO: Accelerometer-recorded daily step counts, self-assessed physical activity, HbA1c, glycemic control, lipid profile, quality of life. | Baseline and after 6 and 24 weeks. | Effect in VO2 peak, self-reported physical activity, and health-related quality of life. | 97% patients reported that the telerehabilitation’s motion sensor was easy to read and use. 89% were willing to use the system after study completion. |
Frederix et al. 2015 [40] Belgium. | Telemoni-toring and personalized feedback in addition to CR. | CR phase II. | 80 (IG:40 CG: 40) | Patients with ACS. | 60 (10) | 83 | PO: Hba1c, lipid profile, VO2 peak, waist circumference, blood pressure, BMI. Re-hospitalization. | Baseline, and after 6 and 18 weeks. | Effects in HbA1c, HDL, VO2 peak. | |
Varnfield et al. 2014 [42] Australia. | Text messages and web-based smartphone application. | Traditional center-based CR. | 120 (IG:60 CG: 60) | Post-MI patients referred to CR. | 55.7 (10.4) | 82 | PO: Uptake, adherence and completion of a CR programme. SO: Modifiable lifestyle factors, biomedical risk factors, waist circumference, lipid profile, health related quality of life. | Baseline, 6-weeks and 6-months. | Effects in uptake, adherence and completion rates, quality of life, blood pressure. |
Reference | Mode of delivery | Materials | Secondary prevention core components | Theoretical framework | Health professionals | Setting | Duration | Intensity | Effect on outcome i, ii and/or iii |
---|---|---|---|---|---|---|---|---|---|
m-health | |||||||||
m-Health. | 4 modules with text messages offered information on major secondary prevention areas; physical activity, diet, smoking cessation, general cardiac education. | MM, HE | Behavioural change technique. | e-Health and traditional exercise based CR. | 6 months. | 96 messages, 1 text message 4 days a week, on random weekdays. | ii | ||
Johnston et al. 2016 [30] | m-Health. | Four main modules: Extended drug adherence e-diary to register daily ticagrelor intake, exercise, weight and smoking. Feedback and information messages General information regarding the cause, symptoms, and treatment of MI. | MM, HE | e-Health and standard secondary prevention care. | 6 months. | i | |||
Fang et al. 2016 [32] | m-Health. | Text messages reminders for medications. Micro letter platform which CAD-related education materials (text, images and media content). | MM, HE | A nurse and a physician. | e-Health | 6 months. | Educational materials and reminders via the Micro letter platform at regular intervals. | i | |
m-Health. | Text messages reminders for medications, text messages education. | MM, HE | Self-efficacy theory. | Nurse. | e-Health | 1 month. | Daily text messages reminders, text messages education 3d/week. | i | |
Khonsari et al.2015 [39] | m-Health. | Text messages reminders for medications, 30-day medication dosage and reminder to come to the hospital and have their prescribed cardiac medication refilled. | MM | e-Health | 2 months. | Daily text messages reminders. | i, ii | ||
Blasco et al. 2012 [44] | m-Health. | Biological and clinical data accessed via telemonitoring, individualized short text messages with recommendations including lifestyle counseling. | SM, MM | Cardiologist. | e-Health and and three clinical visits. | 12 months. | Patients sent, through mobile phones, biological and clinical data weekly, and subsequently received individualized text messages with recommendations. | ii | |
Web-based technology | |||||||||
Norlund et al. 2018 [26] | Web-based technology. | 10 treatment modules with 2–4 treatment steps each, homework assignment, feedback, discussion boards, a library with supplementary material and video clips, and text-based psychoeducation. Self-monitoring of mood and daily activities. | HE, PM, SM | Internet-based cognitive behavioral therapy (iCBT). | Psychologist. | e-Health | 3.5 months | Patients were recommended to work with one step per week. | |
Web-based technology. | An exercise protocol, and diary, heart rate monitor, virtual reality exercise programme composed of 3 modules. | PA | e-Health | 6 months. | The exercise protocol was performed three times a week over 6 months. | ii | |||
Lear et al. 2015 [36] | Web-based technology. | Heart rate monitor and a blood pressure monitor, on-line intake medical, risk factor and lifestyle forms, scheduled one-to-one chat sessions, education sessions (interactive slide presentations), data capture for the exercise test and blood test results, progress notes, and monthly ask-an-expert group chat sessions. | SM, PA, HE | Programme nurse case manager, exercise specialist and dietitian. | e-Health | 3 months. | Chat session three times during 12 weeks, weekly education sessions, monthly ask-an-expert group chat sessions, upload their exercise data at least twice per week. | ii | |
Devi et al. 2014 [41] | Web- based technology. | A online exercise diary recording details of daily exercise, self-monitoring, education on behaviour change techniques, feedback on behaviour goals, information about health consequences, and reducing negative emotions. | HE, SM, PM | Behaviour change techniques. | Cardiac nurses. | e-Health. | 1.5 months. | The participants were told to log in daily to record their daily physical activity. | ii, iii |
Vernooij et al. 2012 [43] | Web- based technology. | Web page containing risk factor measurements, drug use, treatment goal and advice from the nurse, correspondence between nurse and patient, news items for that particular risk factor. Patients were able to submit new measurements, to read and send messages. | MM, SM, HE | Chronic care model. | Nurse. | e-Health and usual care. | 12 months. | The treating nurse practitioner logged in every working day and replied to messages sent by patients and sent messages to patients not using the programme at least every other week. | |
Reid et al. 2011 [45] | Web- based technology. | Five tutorials designed to foster behavioral capability, self-efficacy, social support, and realistic outcome expectations. Following each tutorial a new physical activity plan was developed. Between tutorials, participants received emails from the exercise specialist providing motivational feedback. | HE, PM, PA | Exercise specialist. | e-Health. | 6 months. | Five online tutorials (at weeks 2, 4, 8, 14, and 20). Each online tutorial took between 10 and 20 min to complete. Asked to log daily activity. | ii, iii | |
Lindsay et al. 2009 [46] | Web- based technology. | Discussion groups, one-to-one instant messaging with moderators, glossary and information about CAD, diet, exercise and smoking, links and references to local community resources where they could seek help and advice. | PM, HE | Moderator. | e-Health | 9 months. | The first 6 months the project were moderated, while the remaining 3 months were unmoderated. | ii | |
Southard et al. 2003 [49] | Web- based technology. | Web-based program to provide risk factor management support, education, and monitoring services to patients with CVD. Online assessments, online discussion group, a list of participants’ e-mail addresses, and links to related sites on the Internet. | SM, HE | Nurse case managers. | e-Health. | 6 months. | Logging on to the site at least once a week for 30 min, communicating with a case manager and dietitian, completing education modules, and entering data into progress graphs. | ||
Combination | |||||||||
Widmer et al. 2017 [29] | Combination of m-Health and web-based technology. | Access to health status information, reporting of dietary and exercise habits, graphics showing trends, a social reinforcement networks, educational modules with tasks, targets and plans. | SM, HE, PM | Patient-centered and evidence based material. | Study coordinator. | e-Health and standard phase II CR. | 3 months. | Daily tasks, patients were asked to complete educational tasks on a regular basis. | ii |
Wolf et al. 2016 [31] | Combination of m-Health and web-based technology. | The mobile app consisted of 3 modules: Self-rated fatigue, symptom trend graph, and built in accelerometer. The web page consisted of 5 modules: Self-rated fatigue, symptom trend graph, diary to capture the everyday experience. Chat function with other patients and nurses, personal links to relevant webpages. | SM, PM | PCC approach. | Nurses and a physician. | e-Health and PCC intervention face-to-face. | At least 2 months. | The patients decided on the frequency and patterns of use of the tool. | iii |
Pfaeffli Dale et al. 2015 [33] | Combination of m-Health and web-based technology. | Self-monitoring of physical activity, access to supporting web-page, daily text messages, text an expert to request personalized feedback, health information and recommendation about lifestyle changes via a participant blog, graphs displaying their pedometer step-count, and short video messages from role models and medical professionals. | SM, PM, HE | Social cognitive theory. | e-Health and standard CR. | 6 months. | Daily text messages for 13 weeks. From week 13 to 24 the frequency of messages decreased to 5 per week. Self-monitoring of physical activity with pedometer. | i | |
Maddison et al. 2015 [34] | Combination of m-Health and web-based technology. | Personalized automated package of text messages aimed to increase exercise behaviour, additional information was provided via a web-page including role model video vignettes, an opportunity to self-monitoring progress, and information on various forms of physical activity advice, and links to other website. | PM, SM, HE | The m-Health development and evaluation framework. | e-Health and community-based cardiac rehabilitation. | 6 months. | Six text messages per week for the first 12 weeks, five text messages per week for 6 weeks and then four text messages per week for remaining 6 weeks; total 118 messages. | ii, iii | |
Frederix et al. 2015 [35] | Combination of m-Health and web-based technology. | A patient-specific exercise training protocol, accelerometer for self-monitoring, dietary recommendations, smoking cessation and physical activity tele-coaching strategies, personalized automated feedback emails and text messages encouraging the patients to achieve recommendations. | PA, HE, SM | A health professional who had coached cardiac patients for more than 5 years, supervised by cardiologist. | e-Health and conventional cardiac rehabilitation. | 6 months. | Feedback on email and text messages once weekly. | ii, iii | |
Frederix et al. 2015 [40] | Combination of m-Health and web-based technology. | An accelerometer which registered activity data, personalized automated feedback, emails and text messages designed to encourage the patient to increase daily activity. | PA, HE, SM | e-Health and cardiac rehabilitation phase II. | 4.5 months. | Weekly upload of physical activity data. Weekly personalized feedback on physical activity by email or text message. | ii | ||
Varnfield et al. 2014 [42] | Combination of m-Health and web-based technology. | “My heart, My life” manual, health and exercise monitoring, preinstalled audio and video files, motivational and educational materials delivered via text messages. | SM, HE | e-Health | 1.5 months. | Weekly scheduled telephone consultations (15 min each), weekly consultations via the web portal to provide informed, personalised feedback on progress according to goals set. | i, iii |
Description of the e-Health interventions
m-Health
Modes of delivery | Secondary prevention components | Outcome measures | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Author (year) | m-Health | Web-based | Combination | PA/EM | HE | PM | SM | MM | Adherence to treatment | Modifiable CAD risk factors | Psychosocial outcomes |
Thakkar et al. 2016 [27] | ✓ | ✓ | ✓ |
+
| |||||||
Chow et al. 2015 [28] | ✓ | ✓ | ✓ |
+
| |||||||
Johnston et al. 2016 [30] | ✓ | ✓ | ✓ |
+
|
–
| – | |||||
Park et al. 2015 [37] | ✓ | ✓ | ✓ |
+
| – | ||||||
Park et al. 2014 [38] | ✓ | ✓ | ✓ |
+
| |||||||
Khonsari et al. 2015 [39] | ✓ | ✓ |
+
| ||||||||
Fang et al. 2016 [32] | ✓ | ✓ | ✓ |
–
| |||||||
Blasco et al. 2012 [44] | ✓ | ✓ |
+
| – | |||||||
Southard et al. 2003 [49] | ✓ | ✓ | ✓ |
+
| – | ||||||
Lindsay et al. 2009 [46] | ✓ | ✓ | ✓ |
+
| |||||||
Devi et al. 2014 [41] | ✓ | ✓ | ✓ | ✓ |
+
| + | |||||
Norlund et al. 2018 [26] | ✓ | ✓ | ✓ | ✓ | – | ||||||
Reid et al. 2012 [45] | ✓ | ✓ | ✓ | ✓ |
+
| + | |||||
Lear et al. 2015 [36] | ✓ | ✓ | ✓ | ✓ |
+
| ||||||
Vieira et al. 2018 [47] | ✓ | ✓ | – | ||||||||
Vieira et al. 2017 [48] | ✓ | ✓ |
+
| ||||||||
Vernooij et al. 2012 [43] | ✓ | ✓ | ✓ | ✓ |
–
| ||||||
Widmer et al. 2017 [29] | ✓ | ✓ | ✓ | ✓ |
+
| – | |||||
Wolf et al. 2016 [31] | ✓ | ✓ | ✓ |
–
| + | ||||||
Pfaeffli Dale et al.2015 [33] | ✓ | ✓ | ✓ | ✓ |
+
|
–
| – | ||||
Maddison et al. 2015 [34] | ✓ | ✓ | ✓ | ✓ | ✓ |
+
| + | ||||
Frederix et al. 2015 [40] | ✓ | ✓ | ✓ | ✓ |
+
| ||||||
Frederix et al. 2015 [35] | ✓ | ✓ | ✓ | ✓ |
+
| + | |||||
Varnfield et al. 2014 [42] | ✓ | ✓ | ✓ |
+
|
+
| + |