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Currently submitted to: JMIR mHealth and uHealth

Date Submitted: Jun 5, 2020
Open Peer Review Period: Jun 4, 2020 - Jul 30, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Digital Technology Interventions for Risk Factor Modification in Patients with Cardiovascular Disease: a Systematic Literature Review and Meta-Analysis

  • Adewale Samuel Akinosun; 
  • Rob Polson; 
  • Yohanca Diaz - Skeete; 
  • Hannes De Kock; 
  • Lucia Carragher; 
  • Stephen Leslie; 
  • Mark Grindle; 



Cardiovascular diseases (CVDs) remain one of the commonest causes of early death and disability worldwide with 17.9 million deaths and 422.7 million cases annually. There are approximately 1.7 million inpatient episodes in the UK per year. Approximately 50% of CVD is attributable to lifestyle risk factors. Despite widespread education, personal knowledge and efficacy, many individuals fail to adequately modify these risk factors, even after a cardiovascular event. Digital technologies have been suggested as a viable equivalent and potential alternative to conventional cardiac rehabilitation centre care. However, little is known about the clinical effectiveness of these technologies in bringing about behaviour change in CVD patients at individual level.


This systematic review seeks to 1) identify digital technologies and measure effectiveness of their interventions that have been tested in randomized control trials (RCTs) and 2) summarize their behavioural change and clinical outcome applications, and demographic qualities; for risk factor modification among CVD patients.


Mixed data from studies, extracted from selected research databases and filtered to RCTs only, were analysed using qualitative and quantitative methods.


The use of digital technologies in cardiac patients was associated with improvements in total cholesterol, high density lipoprotein, low density lipoprotein, physical activity, physical inactivity (sedentary), healthy diet and medication adherence (at P≤0.05). However, there were no differences seen in body mass index, triglycerides, blood pressures (diastolic and systolic), blood sugar, alcohol intake and smoking (at P=0.05).


This systematic review concludes that digital technology interventions may have benefit in improving protective behavioural factors (physical activity, healthy diet and medication adherence) and more potent when engaged in multiple behavioural outcome treatment (e.g. medication adherence plus…), but did not appear to reduce risky behavioural factors (smoking, alcohol intake and unhealthy diet) and clinical outcomes (body mass index, diastolic blood pressure, systolic blood pressure and blood sugar, HbA1c).


Please cite as:

Akinosun AS, Polson R, Diaz - Skeete Y, De Kock H, Carragher L, Leslie S, Grindle M

Digital Technology Interventions for Risk Factor Modification in Patients with Cardiovascular Disease: a Systematic Literature Review and Meta-Analysis

JMIR Preprints. 05/06/2020:21061

DOI: 10.2196/preprints.21061


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