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. 2021 Apr 13;9(4):e24271. doi: 10.2196/24271

Table 1.

An overview of the 4 randomized controlled trials included in the systematic review.

Studies Patients randomized to control or intervention group, study duration App features Hospitalizations Quality of life Notable outcomes Comments
Seto et al [22]a 50/50, 6 months

  • Blood pressure and weight daily (Fb)

  • Once a week 1-lead electrocardiography (F)

  • -On-call doctor can be contacted through the app (F)

  • -Active doctor involvement in setting weight targets (Nc)

 No difference observed between groups (P=.1)

  • MLHFQd utilized

  • Improved in the intervention group versus control (P=.05)

 More patients were prescribed with aldosterone antagonists in the intervention group (P=.02)

  • Relatively outdated smartphone technology was utilized

  • Visits to the HFe clinic and nurse workload were increased disproportionately to outcomes
Vuorinen et al [23]a 47/47, 6 months

  • Only buttons are used in user interface (N)

  • Blood pressure, heart rate, and weight daily (F)

  • Assessment of dizziness, dyspnea, palpitations, weakness, edema (F)

  • Measurement history as graphs (F)

  • Active nurse involvement in monitoring patient data, encouraging app use (N)

 No difference observed between groups (P=.35) N/Af

  • More uptitration events of angiotensin-converting enzyme inhibitor/beta blocker medication (P=.04) and downtitration of diuretics (P=.02) in the intervention group versus control

  • Medical staff’s (nurses) time spent for the intervention group was significantly greater versus control (P<.001)

 No difference between groups regarding N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction, and other clinical variables
Hägglund et al [24]g 40/32, 3 months

  • Body weight via wirelessly connected scale daily (F)

  • App-directed diuretics titration (F)

  • Visual analog scale assessment (N)

  • App-directed alert to contact HF center via phone (F)

  • Patient education module (F)

 2.2 less hospital days per patient due to HF for the intervention group versus control (relative risk 0.38; P<.05)

  • KCCQh and SF-36i utilized

  • KCCQ showed significant improvement in the intervention group versus control (P<.05)

 N/A

  • Data were stored in the tablet

  • The intervention included patient education and advices regarding self-care in adherence to the guidelines for HF (eg, consult for increase in diuretics if body weight gain detected)
Athilingam et al [25]a 9/9, 1 month

  • Body weight daily (F)

  • Symptom assessment daily (F)

  • Heart rate and activity monitoring via chest strap (F)

  • Medication tracker and reminder (F)

  • Patient education module (F)

  • Deep breathing and walking exercises (F)

 N/A

  • KCCQ utilized

  • No statistical difference

 Significant improvement regarding self-care management (P=.01) and self-care confidence (P=.03) of the intervention group versus the control group, as appraised by the Self-Care of Heart Failure Index

  • Small sample size

  • Only 72% of the patients concluded the 30-day follow-up

  • Patients stated their preference for the use a smartphone app alone or combined with a wrist wearable tracker over the chest strap

aThe study intervention was smartphone based.

bDenotes functional features (ie, those directly specific to patient self-management).

cDenotes nonfunctional features (ie, those not directly specific to patient self-management features).

dMLHFQ: Minnesota Living with Heart Failure Questionnaire.

eHF: heart failure.

fN/A: not applicable.

gThe study intervention was tablet based.

hKCCQ: Kansas City Cardiomyopathy Questionnaire.

iSF-36: 36-Item Short Form Survey.