The Effectiveness of Mobile Health Application on Dietary Behaviors in Patients with Coronary Artery Disease: A Systematic Review and Meta-Analysis

Abstract

This systematic review aims to evaluate the effectiveness of mobile health application on dietary behaviors in patients with coronary artery disease. 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 Published and unpublished studies in Thai and English from 2012 to 2022 are included in this review. Eligible studies were critically appraised by two reviewers using the JBI critical appraisal instruments (Joanna Briggs Institute [JBI], 2017). Where 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 was CRD42022320586. The search identified 934 potential studies, only 20 studies met the inclusion criteria and finally 7 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) and found that there was a statistical significance between one to 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 suggested that 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 the reviewer focused on only experimental studies (RCT and quasi-experimental studies). Further primary research may fill this gap or further review should clarify effectiveness of mHealth application on dietary behaviors in patients with CAD by looking at a larger number of studies.