Identifying mobile health interventions for post-discharge stroke and myocardial infarction patients: A scoping review

Document Type

Article

Department

Medicine; Cardiology

Abstract

Objectives: Data on postdischarge care for stroke and myocardial infarction (MI) patients remain limited. Logistical barriers, including fragmented communication and poor coordination between patients and physicians, contribute to suboptimal outcomes and hinder secondary prevention. Mobile health (mHealth) offers a promising strategy to support continuity of care. We aimed to synthesise existing literature and evaluate mHealth interventions for postdischarge MI and stroke care.
Design: This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline.
Data sources: PubMed, CINAHIL, Scopus and Cochrane were searched from 26 July 2016 to 5 July 2024.
Eligibility criteria: This scoping review included randomised controlled trials and observational studies published in peer-reviewed journals that evaluated mHealth interventions for postdischarge care in MI and stroke. Studies reporting outcomes such as mortality, functional capacity, readmissions or adverse events were included.
Data extraction and synthesis: Two authors independently extracted and summarised the data. Subsequently, methodological quality was independently assessed by two other authors using the Joanna Briggs Institute checklist.
Results: We identified 31 eligible studies, with 14 631 participants and 59.9 mean years old. Most participants were male. Among these, three (%) originated from low-middle income, seven (%) from upper-middle income and 21 (%) from high-income countries. Overall, we identified 17 studies using mobile apps: eight as a single intervention, and nine combined with remote sensors, seven with SMS, three studies used web-based platforms, two used phone calls, one study combined SMS and phone calls and another used remote sensors only. Multimodal telerehabilitation reported better outcomes compared with single-mode mHealth interventions. Most studies assessed functional capacity (26 studies) and quality of life (21 studies).
Conclusion: This review highlighted increased mHealth uptake among postdischarge MI and stroke patients, including significant underrepresentation of female participants, scarce studies from low-middle-income countries or rural areas and limited reporting of hard clinical endpoints. While mHealth showed positive outcomes across most studies, it further highlights contextual factors that account for digital disparity and the need to prioritise inclusive, user-centred designs and integrate objective measurement tools on future trials and policy frameworks.

Publication (Name of Journal)

BMJ Open

DOI

10.1136/bmjopen-2024-094425.

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