Digital Health Technologies to Promote Lifestyle Change and Adherence.

Cardiovascular disease is the leading cause of morbidity and mortality worldwide with an estimated 17.5 million deaths annually, or 31% of all global deaths, according to the World Health Organization. The majority of these deaths are preventable by addressing lifestyle modification (i.e., smoking cessation, diet, obesity, and physical inactivity) and promoting medication adherence. At present, initiatives to develop cost-effective modalities to support self-management, lifestyle modification, and medication adherence are a leading priority. Digital health has rapidly emerged as technology with the potential to address this gap in cardiovascular disease self-management and transform the way healthcare has been traditionally delivered. However, limited evidence exists about the type of technologies available and how they differ in functionality, effectiveness, and application. We aimed to review the most important and relevant recent studies addressing health technologies to promote lifestyle change and medication adherence including text messaging, applications ("apps"), and wearable devices. The current literature indicates that digital health technologies will likely play a prominent role in future cardiovascular disease management, risk reduction, and delivery of care in both resource-rich and resource-limited settings. However, there is limited large-scale evidence to support adoption of existing interventions. Further clinical research and healthcare policy change are needed to move the promise of new digital health technologies towards reality.