Digital Health Programs to Reduce Readmissions in Coronary Artery Disease

Braver, Justin; Marwick, Thomas H.; Oldenburg, Brian; Issaka, Ayuba; Carrington, Melinda J.

doi:10.1016/j.jacadv.2023.100591

Cited by 4 publications

(14 citation statements)

References 58 publications

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“…24 The basis for this review is an earlier systematic review and meta-analysis that investigated mHealthenabled DMPs to determine their effectiveness in reducing readmissions and mortality in patients with coronary artery disease (CAD). 23 That review compared 18 studies of mHealth-enabled DMPs against standard DMPs. However, in this review we have included 27 studies that were originally eligible for the Braver et al 2023 review to ensure a comprehensive coverage of programs that reported reduction of readmission and mortality in people with heart disease.…”

Section: Methodsmentioning

confidence: 99%

“…The full search strategy is described elsewhere. 23 The inclusion criteria for the 27 studies that were originally eligible for the Braver et al 2023 review is presented. (Table 1).…”

Section: Search Strategy and Screeningmentioning

confidence: 99%

“…18,19,21,61 The use of convenience sampling methods in trials often makes it not possible to draw conclusions on the representativeness of the sample and consequently, limits generalisability of digital-enabled interventions to different socio-demographic groups. The exclusion criteria of the studies, as de ned elsewhere 23 placed several restrictions that reduced access for vulnerable populations, including the elderly, the culturally and linguistically diverse, and those with no access to a smart device or no connectivity to the Internet. Whitelaw et al 2021 62 also reported some common participant-level barriers in the uptake of digital health technologies in cardiovascular care, including di cult-to-use technology, poor Internet connection, and fear of using technology.…”

Section: Re-aim Dimensionsmentioning

confidence: 99%

“…This may be an important factor explaining the bene ts of mHealth enabled DMPs and further supports the ndings from our previous review. 23 All the studies evaluated were digital-enabled interventions for secondary prevention of heart disease and consequently the primary and secondary outcome measures of the interventions were predominantly clinical and behavioural in nature. Reporting of broader outcomes, such as quality of life and participant satisfaction, was rare, even though these outcomes can provide insight into improving the quality of the delivered care as well as intervention compliance.…”

Section: Re-aim Dimensionsmentioning

confidence: 99%

“…Such knowledge would offer guidance to improve the wider implementation and optimisation of digitalenabled interventions for the secondary prevention and management of people with coronary artery disease. This review will ll this gap and its aim is to evaluate the extent to which RE-AIM dimensions and associated internal and external validity indicators are reported in the included studies of a systematic review and meta-analysis 23 that assessed the effectiveness of digital-enabled disease management programs (DMPs) in reducing readmission and mortality in people with heart disease.…”

Section: Introductionmentioning

confidence: 99%

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Optimising the implementation of digital-enabled interventions for the secondary prevention of heart disease: A systematic review using the RE-AIM planning and evaluation framework

Moel-Mandel,

Lynch,

Issaka

et al. 2023

Preprint

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Background Digital-enabled interventions are widely utilised to support the delivery of programs for the secondary prevention of heart disease. They have shown a similar efficacy and safety to centre-based programs and improvements in access and adherence; the key barriers to in-person programs. However, questions remain regarding the successful wider implementation of digital-enabled programs. By applying the RE-AIM framework to a systematic review and meta-analysis, this review aims to evaluate the extent to which these programs report on RE-AIM dimensions and associated indicators. Methods This review extends our previous systematic review and meta-analysis that investigated the effectiveness of digital-enabled programs for coronary artery disease patients after hospitalisation. Citation searches were performed on the 27 studies of the systematic review and meta-analysis to identify linked publications that reported data for RE-AIM dimensions. All included studies and, where relevant, any additional publications, were coded using an adapted RE-AIM extraction tool. Discrepant codes were discussed amongst reviewers to gain consensus. Data were analysed to assess reporting on indicators related to each of the RE-AIM dimensions, and average overall reporting rates for each dimension were calculated. Results Across all 27 studies and nine additional reports, 24 (89%) studies were interventions solely delivered at home. In 11 (46%) of these studies, there were no staff involved in the intervention delivery or staff were only available on request. Ten studies (37%) used a mobile application, and only four (15%) studies did not require access to a smartphone. Across all studies the average reporting rates for RE-AIM dimensions were highest for effectiveness (75%) and reach (67%), followed by adoption (54%), implementation (36%) and maintenance (11%). Conclusions Through the application of the RE-AIM framework to a systematic review, we found most studies failed to report on key indicators. Failing to report these indicators inhibits the ability to address the enablers and barriers required to achieve optimal intervention implementation in wider settings and populations. Future studies should consider indicators in design and report on implementation indicators to improve the translation of research evidence into routine practice, with special consideration given to the long-term sustainability of program effects as well as corresponding ongoing costs. Registration: PROSPERO - CRD42022343030

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Section: Methodsmentioning

confidence: 99%

“…The full search strategy is described elsewhere. 23 The inclusion criteria for the 27 studies that were originally eligible for the Braver et al 2023 review is presented. (Table 1).…”

Section: Search Strategy and Screeningmentioning

confidence: 99%