A meta-analysis published last month in the Mayo Clinic Proceedings shows that, in general, digital health interventions can be of great benefit in improving outcomes for cardiovascular disease. Mayo Clinic researchers poured through 588 abstracts from the past 25 years, eventually winnowing them down to 51 RCTs and cohort studies, encompassing 24,000 patients.
"Although previous studies have suggested benefits of digital health interventions in focused areas such as smoking cessation, behavior patterns, physical activity, hemoglobin A1c, blood pressure, and weight loss, evidence concerning the benefit of digital health interventions on cardiovascular disease risk factors, let alone cardiovascular disease outcomes such as cardiovascular disease events, hospitalizations, and all-cause mortality, is lacking," wrote study authors, led by Dr. Jay Widmer. "With nearly 50,000 health care–related apps now available for download and numerous internet-based digital health intervention solutions available, the benefit of digital health interventions on cardiovascular disease prevention and outcomes, both primary and secondary, merits reexamination."
Researchers found that, on average, digital health interventions (which included telemedicine, Web-based modalities, email reminders, SMS texting, mobile application, and data monitoring) reduced relative risk for cardiovascular disease outcomes by 40 percent -- a better reduction than statins, aspirin, or antihypertension drugs.
They also found that in general, digital health interventions reduced weight loss, BMI, blood pressure, and low-density lipoprotein cholesterol, but these reductions didn't always correspond to a cardiovascular disease risk.
Not all digital health interventions performed the same, either. When researchers broke down the different modalities, they found web-based, SMS, and telemedicine interventions most effective, while emails and data monitoring were least effective. The one exception was that data monitoring was beneficial for reducing diastolic blood pressure.
The meta-analysis is promising but, researchers warn, it doesn't tell the whole story.
"Because digital health intervention use does not directly reduce cardiovascular disease risk, these observed benefits likely reflect increased adherence to evidence-based preventive therapies such as statins, aspirin, or beta blockers," they write. "In addition, this analysis was unable to assess behavior change and motivational techniques, either of which could impact the outcomes of trials or be a contributor to DHI efficacy. Research attempting to better assess these issues will be vital in future work."