Digital health applications: A game-changer in post-hospitalisation heart failure care

According to a study published in the International Journal of Cardiology, the use of electronic health services via health applications after heart failure (HF) hospitalisation notably enhances patient outcomes and reduces mortality risk.

The research team aimed to scrutinise the effectiveness of digital health interventions (DHI) in comparison to conventional care for patients who had previously been hospitalised due to HF. To do this, they performed a retrospective study involving ten randomised controlled trials listed on databases such as MEDLINE, Cochrane, OVID, CINHAL, and ERIC. The trials studied the effects of DHI on patients with HF. The sample size comprised 7204 patients, predominantly men, with an average age of 65.7 years. These patients were followed for nearly 16 months, with all-cause death being the primary outcome measured.

Upon comparing the group utilising DHI with the standard care group, researchers discovered a reduction in all-cause mortality (8.5% vs. 10.2%; risk ratio [RR], 0.80; 95% CI, 0.66-0.96; P =.02) as well as cardiovascular mortality (7.3% vs. 9.6%; RR, 0.76; 95% CI, 0.62-0.94; P =.01). However, the study found no significant difference in HF-related hospitalisations (23.4% vs. 26.2%; RR, 0.82; 95% CI, 0.66-1.02; P =.07) and all-cause hospitalisations (48.3% vs. 49.9%; RR, 0.89; 95% CI, 0.77-1.03; P =.11).

Further, the DHI group experienced fewer lost days due to HF-related hospitalisations when compared with the standard care group (mean difference [MD], -1.77; 95% CI, -3.06 to -0.48; P =.01; I2 = 51). However, the number of days lost to all-cause hospitalisations was similar in both groups (MD, -0.76; 95% CI, -3.07 to -1.55; P =.52; I2 = 69).

The study had certain limitations, including reliance on study-level data rather than individual patient data, the meta-analysis research design, variability in certain study endpoints, and a lack of representation of women in the study group.

The authors of the study concluded, “This meta-analysis of randomised controlled trials supports a reduction in all-cause and cardiovascular mortality, with less total time spent in HF hospitalisations when DHI is employed in patients with prior HF hospitalisations.” They further highlighted the need for more extensive studies to examine different types of DHI and assess their cost-effectiveness in managing HF.