Centre for Research in Nursing and Health, St George Hospital, Kogarah, New South Wales, Australia (Ms Shi, Dr Green, Mr Sikhosana, and Dr Fernandez); Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, and Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia (Ms Shi); Faculty of Medicine and Health, University of Newcastle, Callaghan, New South Wales, Australia (Mr Sikhosana and Dr Fernandez); and School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, and Centre for Evidence based Initiatives in Health Care: A JBI Centre for Excellence, Wollongong, New South Wales, Australia (Dr Green).
J Cardiopulm Rehabil Prev. 2024 Jan 1;44(1):15-25. doi: 10.1097/HCR.0000000000000807. Epub 2023 Jun 20.
The aim of this study was to conduct an umbrella review summarizing the evidence from existing systematic reviews of telehealth cardiac rehabilitation (CR) on health outcomes of patients with coronary heart disease (CHD).
An umbrella review of systematic reviews was undertaken in accordance with the PRISMA and JBI guidelines. A systematic search was conducted in Medline, APA PsycINFO, Embase, CINAHL, Web of Science, Cochrane database of systematic reviews, JBI evidence synthesis, Epistemonikos, and PROSPERO, searching for systematic reviews published from 1990 to current and was limited to the language source of English and Chinese. Outcomes of interest were health behaviors and modifiable CHD risk factors, psychosocial outcomes, and other secondary outcomes. Study quality was appraised using the JBI checklist for systematic reviews. A narrative analysis was conducted, and meta-analysis results were synthesized.
From 1301 identified reviews, 13 systematic reviews (10 meta-analyses) comprised 132 primary studies conducted in 28 countries. All the included reviews have high quality, with scores ranging 73-100%. Findings to the health outcomes remained inconclusive, except solid evidence was found in the significant improvement in physical activity (PA) levels and behaviors from telehealth interventions, exercise capacity from mobile health (m-health) only and web-based only interventions, and medication adherence from m-health interventions. Telehealth CR programs, work adjunct or in addition to traditional CR and standard care, are effective in improving health behaviors and modifiable CHD risk factors, particularly in PA. In addition, it does not increase the incidence in terms of mortality, adverse events, hospital readmission, and revascularization.
本研究旨在进行伞式综述，总结现有远程心脏康复（CR）系统评价的证据，以评估其对冠心病（CHD）患者健康结局的影响。
按照 PRISMA 和 JBI 指南进行伞式综述。系统检索了 Medline、APA PsycINFO、Embase、CINAHL、Web of Science、Cochrane 系统评价数据库、JBI 证据综合数据库、Epistemonikos 和 PROSPERO，检索时间从 1990 年至今，语言来源限于英语和中文。感兴趣的结局包括健康行为和可改变的 CHD 风险因素、心理社会结局和其他次要结局。使用 JBI 系统评价清单评估研究质量。进行了叙述性分析，并对荟萃分析结果进行了综合。
从 1301 篇综述中，确定了 13 项系统综述（10 项荟萃分析），其中包括 28 个国家的 132 项初级研究。所有纳入的综述质量都很高，评分范围为 73-100%。除了远程健康干预显著改善身体活动（PA）水平和行为、移动健康（m-health）和仅基于网络的干预显著改善运动能力、m-health 干预显著提高药物依从性等健康结局的证据确凿外，其他健康结局的结论仍不确定。远程心脏康复（CR）计划作为传统 CR 和标准护理的补充或附加手段，可有效改善健康行为和可改变的 CHD 风险因素，特别是在 PA 方面。此外，它不会增加死亡率、不良事件、住院再入院和血运重建的发生率。
