Post-percutaneous coronary intervention (PCI) management is essential for improving patient outcomes. Digital health services (DHS) offer the potential to enhance recovery outcomes and care quality through real-time monitoring and personalized interventions.

This systematic review and meta-analysis aims to evaluate the effectiveness and safety of DHS in improving outcomes for post-PCI patients.

A systematic search of databases was conducted for randomized controlled trials on DHS for post-PCI patients.

Eleven studies involving 2568 patients were included. DHS significantly improved quality of life, 6-minute walk test performance, medication adherence, patient satisfaction, and smoking cessation rates, while reducing complications and readmission rates. Subgroup analysis showed DHS was particularly effective for patients over 60 years.

DHS significantly improve post-PCI management and patient outcomes, with marked benefits for older patients. Further large-scale, long-term studies are recommended to confirm these findings.

Coronary artery disease (CAD) is a major health problem of atherosclerotic cardiovascular (CV) disease and early intervention is regarded important. Given the proven effect of a lifestyle intervention with nursing telephone counselling and mHealth use in health care, yet the comparisons of both support are lacking, this study is proposed.

This study aimed to compare the effects of a coronary artery disease (CAD) support program using a mobile application versus nurse phone advice on exercise amount and physical and psychological outcomes for clients at risk of CAD.

A prospective randomized controlled trial was conducted. Ethical approval was obtained. Two-hundred and twenty-six clients were screened, and a total of 168 clients who were at risk of CAD and routinely used smartphones were randomized into the app support group (App group) or the nurse phone advice (NPA) group. Although all participants received the same health talk delivered by a cardiac nurse at the community center, the App group received additional CAD app support, whereas the NPA group received nurse phone advice for 20 min monthly. The app content comprised (1) CAD knowledge in 10 modules, (2) individual exercise records with their own goals and health measures, and (3) a chest pain action list. The intervention lasted for 3 months. Health outcome data were collected at baseline (T0) and after 1 (T1) and 3 (T2) months. The outcomes were the total amount of exercise (primary outcome), self-efficacy in illness management, perceived stress, and CAD risk profile (body weight, body mass index, and lipid concentration). Generalized estimating equation models were used to assess differential changes in all outcomes within 3 months.

The attrition rates at 3 months were 3.49% and 9.30% for the App and NPA groups, respectively. The App support group was superior to the NPA group in significantly increasing total exercise amount and reducing body weight, waist circumference, triglycerides, and increased self-efficacy in illness management.

The result provides further insights of app development to support health promotion programs for community-dwelling adults at risk of CAD.

Nowadays, the mHealth market is flooded with smartphone applications (apps) lacking validation for blood pressure (BP)-lowering effects and BP measurement accuracy. This systematic review for Guidelines for BP control using digital technologies of the Japanese Society of Hypertension aimed to assess the validation studies of apps. We searched eligible studies in Ovid MEDLINE, Cochrane Library, and Ichushi, focusing on randomized controlled trials and observational studies comparing the effects of smartphone app-based interventions with non-digital healthcare. Random effects models of meta-analysis were employed to estimate the pooled effects of mean BP change and 95% confidence intervals (CIs). Out of 7385 studies screened, 76 studies with 46,459 participants were included. The interventions were significantly associated with a reduction in office systolic and diastolic BP at six months (systolic BP, -2.76 mmHg, 95% CI: -3.94 to -1.58; diastolic BP, -1.23 mmHg, -1.80 to -0.67). Normotensives saw a significant reduction in office systolic BP at three-month (-4.44 mmHg, -6.96 to -1.92), diminishing afterward (six-month, 0.86 mmHg, -2.81 to 4.52; twelve-month, 0.86 mmHg, -2.81 to 4.52). Conversely, hypertensive participants experienced a significant reduction in office systolic BP at both three- and six-month (three-month, -7.71 mmHg, -10.63 to -4.79; six-month, -1.88 mmHg, -3.41 to -0.35), albeit with limited evidence thereafter. A larger BP reduction was observed among participants using apps with wireless transmission of BP measurements (P = 0.047 for interaction), while there was no clear difference in BP reduction according to the presence of other functions. Smartphone app-based interventions may hold the potential to improve BP levels.

Chronic diseases such as diabetes and cardiovascular disease are global health challenges, affecting millions of people worldwide. Traditional health care often falls short in chronic disease management. This has led to the exploration of innovative solutions, such as mobile health (mHealth) technologies. mHealth, which leverages mobile and wireless technologies, has the potential to transform health care delivery by providing continuous, accessible, and personalized care. However, the effectiveness of mHealth, particularly when integrated with traditional health care interventions delivered by professionals, warrants comprehensive investigation. Understanding the combined impact of mHealth and professional-led interventions is critical to maximizing the potential of mHealth to improve patient outcomes and adherence.

This study aims to investigate the effectiveness of combining mHealth and health professional-led intervention for improving health-related outcomes in chronic diseases.

This systematic review and meta-analysis focused on randomized controlled trials. We searched Web of Science, CENTRAL, MEDLINE, and CINAHL through July 17, 2023. The study targeted patients aged 18 years and older, experiencing at least 1 chronic condition. The interventions were a combination of mHealth and the use of a health care professional. The comparison groups consisted of participants receiving either general care and follow-up or those using mHealth devices without any health care professional involvement. The outcomes measured in this review included hemoglobin A1c (HbA1c), quality of life (QoL), and physical activity.

The study included 26 research papers, encompassing 7360 individuals. Meta-analysis was conducted for HbA1c, QoL, and physical activity. For HbA1c, short-term improvement was significant (standardized mean difference [SMD] -0.43; 95% CI -0.64 to -0.21; I2=69%) and medium term (SMD -0.49; 95% CI -0.49 to -0.09; I2=21%). However, in the long term, the improvement was not significant (SMD -0.23; 95% CI -0.49 to 0.03; I2=88%). For QoL, significant improvements were observed in the short term (SMD -0.23; 95% CI -0.42 to -0.05; I2=62%), and in the medium term (SMD -0.16; 95% CI -0.24 to -0.07; I2=0%). In the long term, however, the improvement was not significant (SMD -0.12; 95% CI -0.41 to 0.16; I2=71%). For physical activity, both subjective (questionnaire) and objective (number of steps) outcomes were analyzed. In the short term, subjective outcomes showed significant improvement (SMD 0.31; 95% CI 0.12-0.50; I2=0%), while objective outcomes did not (SMD 0.11; 95% CI -0.05 to 0.27; I2=0%). Medium- and long-term subjective outcomes showed no significant improvement. Meta-analysis for objective outcomes in the medium and long term was not possible due to insufficient studies.

This study confirmed short- and medium-term benefits of mHealth combined with professional interventions for HbA1c, QoL, and short-term physical activity, supporting effective chronic disease management.

Hypertension, characterized by high blood pressure, poses a significant risk for cardiovascular diseases, stroke, and heart attack. Managing it is particularly challenging in areas with limited healthcare access and for patients who cannot attend regular in-person visits. Telemedicine interventions offer a promising solution by improving patient adherence and facilitating timely treatment adjustments. This study aims to systematically evaluate the impact of these telemedicine interventions on reducing systolic and diastolic blood pressure.

A comprehensive search of PubMed, Scopus, and Web of Science was conducted to identify relevant studies. Two independent reviewers screened and selected eligible articles, extracting key data using a standardized form. The quality of the included studies was assessed with the Mixed Methods Appraisal Tool (MMAT). A random effects model was used to combine the results, with treatment effects measured using standardized mean differences (Hedges's g). Consistency of findings was evaluated through statistical tests, including the Q test and I² statistic, to assess heterogeneity. Data analysis was conducted using Stata statistical software version 17.0.

Of the 2700 articles retrieved, 35 studies were selected for inclusion in the analysis. Using a random-effects model, the overall effect size was Hedges's g = -0.22 (95% CI: -0.30 to -0.15; p-value < 0.001), indicating a small but meaningful reduction in blood pressure (systolic and diastolic). Telemedicine interventions had a greater impact on systolic blood pressure (Hedges's g = -0.27, 95% CI: -0.39 to -0.15; p-value < 0.001) compared to diastolic blood pressure (Hedges's g = -0.17, 95% CI: -0.26 to -0.07; p-value < 0.001), though both reductions were clinically relevant.

This study demonstrates that telemedicine interventions significantly reduce both systolic and diastolic blood pressure, with a more pronounced effect on systolic pressure. The overall effect size indicates a small but meaningful improvement in hypertension management. These findings highlight the potential of telemedicine as an effective strategy for enhancing patient outcomes in hypertension care.

There are relatively few studies on continuing care of coronary heart disease (CHD), and its research value needs to be further clarified.

To investigate the effect of continuous nursing on treatment compliance and side effect management in patients with CHD.

This is a retrospective study with patients from January 2021 to 2023. The study was divided into two groups with 30 participants in each group. Self-rating anxiety scale (SAS) and Self-rating depression scale (SDS) were used to assess patients' anxiety and depression, and medical coping questionnaire was used to assess patients' coping styles. The pelvic floor dysfunction questionnaire (PFDI-20) was used to assess the status of pelvic floor function, including bladder symptoms, intestinal symptoms, and pelvic symptoms.

SAS score decreased from 57.33 ± 3.01before treatment to 41.33 ± 3.42 after treatment, SDS score decreased from 50.40 ± 1.45 to 39.47 ± 1.57. The decrease of these two indexes was statistically significant (P < 0.05). PFDI-20 scores decreased from the mean 16.83 ± 1.72 before treatment to 10.47 ± 1.3the mean after treatment, which was statistically significant (P < 0.05).

The results of this study indicate that pioneering research in continuous care of CHD has a positive impact on improving patients' treatment compliance, reducing anxiety and depression levels, and improving coping styles and pelvic floor functional status.

Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events (MACE) and require readmission after Coronary Artery Bypass Grafting (CABG) surgery. This is often attributed to patients' unhealthy lifestyles and dietary habits, inadequate understanding of the disease, and poor disease management compliance. Thus, searching for more targeted nursing intervention models that can enhance patients' self-management abilities and reduce the risk of readmission after CABG surgery is significant.

To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.

A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample. The patients were divided into two groups using an odd-even number grouping method. The control group received routine nursing care, while the case management group received specialized nursing outpatient case management. The differences in psychological status, adherence to medical treatment, self-care ability, knowledge mastery, quality of life scores, and the occurrence rate of MACE were compared between the two groups.

After the intervention, the case management group had lower scores on the self-rating depression scale and self-rating anxiety scale and lower MACE rate, as well as higher scores for adherence to a healthy diet, medication adherence, good lifestyle habits, regular exercise, and timely follow-up, higher scores on the Coronary Heart Disease Self-Management Scale, higher scores for managing adverse habits, symptoms, emotional cognition, emergency response, disease knowledge, general lifestyle, and treatment adherence, higher scores for understanding coronary heart disease, recognizing the importance of medication adherence, understanding self-care points after CABG surgery, and being aware of post-CABG precautions, higher scores for physical well-being, disease condition, general health, social-psychological well-being, and work-related aspects (P < 0.05).

Specialized nursing outpatient case management can enhance patient adherence to medical treatment, knowledge mastery, psychological well-being, and overall quality of life in patients after CABG surgery.

Mobile health applications (apps) have gained significant popularity and widespread utilization among patients with coronary heart disease (CHD). The objective of this study is to evaluate the effects of mHealth apps on clinical outcomes and health behaviors in patients with CHD.

Databases were searched from inception until December 2023, including Cochrane Library, PubMed, EMBASE, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Service System (SinoMed), Wanfang Data, China Science and Technology Journal Database (VIP), for randomized controlled trials (RCTs) regarding the effectiveness of mHealth apps in patients with CHD. Two researchers conducted a comprehensive review of the literature, extracting relevant data and evaluating each study's methodological quality separately. The meta-analysis was performed utilizing Review Manager v5.4 software.

A total of 34 RCTs were included, with 5,319 participants. The findings demonstrated that using mHealth apps could decrease the incidence of major adverse cardiac events (RR = 0.68, P = 0.03), readmission rate (RR = 0.56, P < 0.001), total cholesterol (WMD = -0.19, P = 0.03), total triglycerides (WMD = -0.24, P < 0.001), waist circumference (WMD = -1.92, P = 0.01), Self-Rating Anxiety Scale score (WMD = -6.70, P < 0.001), and Self-Rating Depression Scale score (WMD = -7.87, P < 0.001). They can also increase the LVEF (WMD = 6.50, P < 0.001), VO2 max (WMD = 1.89, P < 0.001), 6-min walk distance (6MWD) (WMD = 19.43, P = 0.004), Morisky Medication Adherence Scale-8 score (WMD = 0.96, P = 0.004), and medication adherence rate (RR = 1.24, P = 0.03). Nevertheless, there is no proof that mHealth apps can lower low-density lipoprote in cholesterol, blood pressure, BMI, or other indicator (P > 0.05).

Mobile health apps have the potential to lower the incidence of major adverse cardiac events (MACEs), readmission rates, and blood lipids in patients with CHD. They can also help enhance cardiac function, promote medication adherence, and alleviate symptoms of anxiety and depression. To further corroborate these results, larger-scale, multi-center RCTs with longer follow-up periods are needed.

This study aimed to explore the association between health status (physical, mental, and self-rated health) and multidimensional poverty (subjective and objective poverty) in older adults.

A panel binary logit regression approach was applied to four waves of CLHLS data (2008, 2011, 2014, and 2018). In total,1,445 individuals were included after data cleaning.

The mean values and proportion of physical, mental, and self-rated health were 5.73 (87.42%), 0.93 (93.06%), and 3.46 (86.7%), respectively, and mean values and proportion of subjective and objective poverty were 0.19 (18.51%) and 0.21(21.4%). In addition, physical, mental, and self-rated health were all found to be associated with subjective poverty among older adults (r = -0.181, r = -0.630, r = -0.321, p < 0.05), that is, the better the physical, mental, and self-rated health, the lower the probability of subjective poverty. A comparable connection between self-rated health and objective poverty also exists (r = -0.157, p < 0.05). Furthermore, medical expenditure played a mediation role in the association between the health status and poverty of older adults.

In order to effectively alleviate the poverty of older adults, strategies should be taken to improve the health level of older adults, especially the physical and mental health of high-aged older adults, and the self-rated health of middle-aged older adults. Furthermore, social security and pensions should be further developed to adequately reimburse medical expenditures.

This qualitative study elicited beliefs about medication adherence among hypertensive seniors with polypharmacy.

Twenty-one participants aged 60 or older with hypertension and other chronic conditions, with or without their family caregivers, residing surrounding Yogyakarta province, using five medicines or more routinely, were semi-structuredly interviewed by one researcher or one research assistant in January to April 2022. Behavioral, normative, and control beliefs were elicited using an interview guideline which was developed based on the Theory of Planned Behavior approach. Thematic analysis was applied.

The participants believed that taking medicines routinely was advantageous because the medicines kept their body in good condition and prevented disease worsening. However, there were concerns about the medications' harmful effects on kidneys, gastric, and the whole body, and that the medicines would not be effective anymore. Prescribers, family, and friends would likely approve of medication adherence. However, non-prescriber doctors, family, and neighbors, mainly those with experience with complementary/alternative medicines, would likely disapprove of medication adherence. Good physical and cognitive function, help from family and technology, mealtime regularity, a simple regimen and easy-to-read medication labeling, and good communication with prescribers were among the facilitators of medication adherence. Physical and cognitive decline, mealtime irregularity, tablets that must be cut before taken, insurance that does not cover all medicines, change in dosage regimen, and hard-to-tear-off medication packaging were among the barriers to medication adherence.

Understanding these beliefs yields insights into the health communication approaches to improving seniors' medication adherence.

Hypertension is a growing public health concern worldwide. It is a leading risk factor for all-cause mortality and may lead to complications such as cardiovascular disease, stroke, and kidney failure. Poor compliance of hypertensive patients is one of the major barriers to controlling high blood pressure. Compliance is not ideal among Chinese patients, and increasing patient self-care compliance with hypertension is necessary.

This article analyzes the status of self-care compliance, trust, and satisfaction among Chinese hypertensive patients using cross-sectional data from Zhejiang Province. We use a multi-group structural equation model (MGSEM) to compare the interrelationships across genders.

The study's findings show that the average trust, satisfaction, and compliance scores are 3.92 ± 0.55, 3.98 ± 0.61, and 3.33 ± 0.41, respectively. Female patients exhibit higher average total scores for trust and compliance than male patients. The SEM results indicate that trust has a direct positive association with compliance [β = 0.242, 95% CI: (0.068, 0.402)] and satisfaction [β = 0.260, 95% CI: (0.145, 0.367)], while their satisfaction is not directly associated with compliance. The results of MGSEM show that trust has an indirect effect on compliance in the male group through satisfaction [β = 0.051, P < 0.05, 95% CI: (0.012, 0.116)]. In the female group, trust has a direct effect on satisfaction [β = 0.235, P < 0.05, 95% CI: (0.041, 0.406)] and compliance [β = 0.319, P < 0.01, 95% CI: (0.086, 0.574)].

This study reveals the mechanisms of self-care compliance, trust, and satisfaction among Chinese hypertensive patients. Its findings may serve as a reference for guiding primary healthcare providers to improve hypertension patients' compliance and implement gender-targeted health interventions.