Department of Cardiology, Prince of Wales Hospital, Sydney, Australia.
Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia.
JMIR Mhealth Uhealth. 2020 Jul 6;8(7):e16695. doi: 10.2196/16695.
Cardiovascular disease (CVD) remains the leading cause of death worldwide. Mobile phones have become ubiquitous in most developed societies. Smartphone apps, telemonitoring, and clinician-driven SMS allow for novel opportunities and methods in managing chronic CVD, such as ischemic heart disease, heart failure, and hypertension, and in the conduct and support of cardiac rehabilitation.
A systematic review was conducted using seven electronic databases, identifying all relevant randomized control trials (RCTs) featuring a mobile phone intervention (MPI) used in the management of chronic CVD. Outcomes assessed included mortality, hospitalizations, blood pressure (BP), and BMI.
Electronic data searches were performed using seven databases from January 2000 to June 2019. Relevant articles were reviewed and analyzed. Meta-analysis was performed using standard techniques. The odds ratio (OR) was used as a summary statistic for dichotomous variables. A random effect model was used.
A total of 26 RCTs including 6713 patients were identified and are described in this review, and 12 RCTs were included in the meta-analysis. In patients with heart failure, MPIs were associated with a significantly lower rate of hospitalizations (244/792, 30.8% vs 287/803, 35.7%; n=1595; OR 0.77, 95% CI 0.62 to 0.97; P=.03; I=0%). In patients with hypertension, patients exposed to MPIs had a significantly lower systolic BP (mean difference 4.3 mm Hg; 95% CI -7.8 to -0.78 mm Hg; n=2023; P=.02).
The available data suggest that MPIs may have a role as a valuable adjunct in the management of chronic CVD.
心血管疾病（CVD）仍然是全球范围内的主要死因。在大多数发达国家，手机已经无处不在。智能手机应用程序、远程监测以及临床医生驱动的短信使得管理慢性 CVD（如缺血性心脏病、心力衰竭和高血压）以及进行和支持心脏康复成为可能。
本研究使用七个电子数据库进行了系统评价，确定了所有使用手机干预（MPI）管理慢性 CVD 的相关随机对照试验（RCT）。评估的结局包括死亡率、住院率、血压（BP）和体重指数（BMI）。
使用七个数据库从 2000 年 1 月至 2019 年 6 月进行电子数据搜索。对相关文章进行了审查和分析。使用标准技术进行了荟萃分析。二分类变量使用比值比（OR）作为汇总统计量。使用随机效应模型。
共确定了 26 项 RCT，纳入了 6713 名患者，并在本综述中进行了描述，其中 12 项 RCT 纳入了荟萃分析。在心力衰竭患者中，MPI 与住院率显著降低相关（244/792，30.8%vs287/803，35.7%；n=1595；OR0.77，95%CI0.62 至 0.97；P=.03；I=0%）。在高血压患者中，暴露于 MPI 的患者收缩压显著降低（平均差异 4.3mmHg；95%CI-7.8 至-0.78mmHg；n=2023；P=.02）。
现有数据表明，MPI 可能在慢性 CVD 的管理中发挥有价值的辅助作用。
