Effectiveness of mHealth Application on Dietary Behaviors in Patients with Coronary Artery Disease : A systematic Review and Meta-analysis
Keywords:
Systematic Review, mHealth Application, Diet, Coronary Artery DiseaseAbstract
This systematic review aimed to evaluate the effectiveness of mHealth application on dietary behaviors in patients with coronary artery disease (CAD). The randomized control trial and quasi-experimental studies, which investigated the effectiveness of mHealth application on dietary behaviors in patients with CAD, were selected for searching review materials in this study. Published and unpublished studies in Thai and English from 2012 to 2022 were included in the review. Eligible studies were critically appraised by two reviewers using the JBI critical appraisal instruments (Joanna Briggs Institute [JBI], 2017). When possible, studies were pooled using meta-analysis. Where statistical pooling was not possible, the findings were presented in narrative form. The degree of certainty of the evidence on clinical outcomes was assessed using the GRADE approach. Systematic review registration number is CRD42022320586.
While the search identified 934 potential studies, only 20 of them met the inclusion criteria and, finally seven studies passed the criteria for critical appraisal assessment. Six studies could be analyzed by meta-analysis and one study for narrative summary. The result found that the mHealth application improved dietary behavior in patients with CAD (SMD 0.30, 95% CI 0.09 to 0.51, (p=.006)). There was a statistical significance between one and three months (SMD 0.30, 95% CI -0.01 to 0.53, (p=.059)). The certainty of evidence for each outcome ranged from very low to moderate level.
This systematic review suggests that using a mHealth application is one option for improving dietary behaviors in patients with CAD for the first three months. The limitation of this review is that it was only focused on experimental studies (RCT and quasi-experimental studies). Further primary research may fill this gap or further review should clarify effectiveness of mHealth applications on dietary behaviors in patients with CAD.
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