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June 8, 2018

Apps could improve heart disease risk management, but questions remain

A study regarding the medical impacts of mobile health (mHealth) technology has found that it has the potential to transform the way heart disease is prevented and managed, but key questions remain regarding the efficacy of cardiac risk management via smartphone apps and text messages.

By Charlotte Edwards

A study regarding the medical impacts of mobile health (mHealth) technology has found that it has the potential to transform the way heart disease is prevented and managed, but key questions remain regarding the efficacy of cardiac risk management via smartphone apps and text messages.

The study, which was published in the Canadian Journal of Cardiology, involved a team of researchers from the University of Sydney reviewing randomised clinical trials (RCTs) to see if mHealth technology could improve the delivery of cardiovascular prevention in a scalable and affordable way.

University of Sydney professor of medicine and lead investigator of the study Clara Chow said: “mHealth interventions are a novel, exciting, and expanding field in medicine that will potentially transform healthcare delivery by improving access to treatments that would otherwise require frequent clinic or hospital visits.

“There are already an overwhelming number of cardiovascular mHealth options available to consumers. However, the utility of applications to improve health outcomes has been poorly evaluated. There is limited research evidence for their effectiveness in modifying objective measures of health, and app development and provision are largely unregulated.”

During the study, the researchers reviewed evidence on mHealth interventions for simultaneous multiple risk factor reduction in both primary and secondary prevention settings, using smartphone apps and text messages.

For the primary prevention settings, investigators found only a few RCTs that assessed mHealth approaches using text messaging and could not identify any RCTs that assessed the effect of mHealth apps on total cardiovascular risk. The previous studies they reviewed included a 12-month investigation of informative cardiovascular messages and phone calls among 589 workers in China, which resulted in a significantly lower mean ten-year cardiovascular disease risk score in the intervention group compared to the control group.

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The researchers also evaluated the results of three RCTs for secondary prevention using smartphone apps. In general, no or small improvements in the disease risk factors were found. However, they did conclude that the small trial sizes meant they were unlikely to detect small improvements in cardiovascular risk factors. Overall, it was suggested that there is a potential for reducing health service utilisation and hospitalisation, but that further research is required.

Lead author of the study Harry Klimis said: “mHealth has great potential to prevent heart disease, but there are unanswered questions about how to optimise it and maintain engagement with patients.

“Select studies such as TEXT ME, show that mHealth can improve overall heart disease risk. However, our goal needs to be high-quality and effective mHealth interventions. Importantly, future mHealth producers should collaborate with clinicians and regulatory agencies to ensure the interventions are safe and effective and outcome measures standardised.”

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