Caring Futures Institute (CFI), College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, SA 5042, Australia.
Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, Northern Territory 0871, Australia.
Eur Heart J Qual Care Clin Outcomes. 2023 Jun 21;9(4):323-330. doi: 10.1093/ehjqcco/qcad005.
To consolidate the evidence on the effectiveness of activity-monitoring devices and mobile applications on physical activity and health outcomes of patients with cardiovascular disease who attended cardiac rehabilitation (CR) programmes.
An umbrella review of published randomized controlled trials, systematic reviews, and meta-analyses was conducted. Nine databases were searched from inception to 9 February 2022. Search and data extraction followed the JBI methodology for umbrella reviews and PRISMA guidelines. Nine systematic reviews met the inclusion criteria, comparing outcomes of participants in CR programmes utilizing devices/applications, to patients without access to CR with devices/applications. A wide range of physical, clinical, and behavioural outcomes were reported, with results from 18 712 participants. Meta-analyses reported improvements in physical activity, minutes/week [standardized mean difference (SMD) 0.23, 95% confidence interval (CI) 0.10-0.35] and activity levels (SMD 0.29, 95% CI 0.07-0.51), and a reduction in sedentariness [risk ratio (RR) 0.54, 95% CI 0.39-0.75] in CR participants, compared with usual care. Of clinical outcomes, the risk of re-hospitalization reduced significantly (RR 0.49, 95% CI 0.27-0.89), and there was reduction (non-significant) in mortality (RR 0.27, 95% CI 0.05-1.54). From the behavioural outcomes, reviews reported improvements in smoking behaviour (RR 0.87, 95% CI 0.67-1.13) and total diet quality intake (RR 0.79, 95% CI 0.66-0.94) among CR patients.
The use of devices/applications was associated with increase in activity, healthy behaviours, and reductions in clinical indicators. Although most effect sizes indicate limited clinical benefits, the broad consistency of the narrative suggests devices/applications are effective at improving CR patients' outcomes.
总结活动监测设备和移动应用程序对参加心脏康复（CR）计划的心血管疾病患者的身体活动和健康结果的有效性证据。
对已发表的随机对照试验、系统评价和荟萃分析进行了伞式综述。从建库到 2022 年 2 月 9 日，在 9 个数据库中进行了检索。搜索和数据提取遵循 JBI 伞式综述方法和 PRISMA 指南。9 项系统评价符合纳入标准，比较了使用设备/应用程序的 CR 计划参与者和无 CR 设备/应用程序的患者的结果。报告了广泛的身体、临床和行为结果，涉及 18712 名参与者。荟萃分析报告称，与常规护理相比，CR 参与者的身体活动量增加，每周分钟数[标准化均数差（SMD）0.23，95%置信区间（CI）0.10-0.35]和活动水平[SMD 0.29，95%CI 0.07-0.51]提高，久坐行为减少[风险比（RR）0.54，95%CI 0.39-0.75]。在临床结果方面，再住院风险显著降低（RR 0.49，95%CI 0.27-0.89），死亡率降低（RR 0.27，95%CI 0.05-1.54）但无统计学意义。从行为结果来看，综述报告称 CR 患者的吸烟行为（RR 0.87，95%CI 0.67-1.13）和总体饮食质量摄入（RR 0.79，95%CI 0.66-0.94）有所改善。
使用设备/应用程序与活动增加、健康行为改善以及临床指标降低有关。尽管大多数效应量表明临床获益有限，但叙述的广泛一致性表明设备/应用程序在改善 CR 患者的结果方面是有效的。
