The effectiveness of the use of consumer health information technology in patients with heart failure: A meta-analysis and narrative review of randomized controlled trials

Purpose: The purpose of this study was to examine whether the use of consumer health information technologies (CHITs) has an impact on outcomes of patients in the self-management of heart failure (HF). Methods: A literature search of six electronic databases was conducted to identify relevant reports of randomized controlled trials (RCTs) for the analysis. Mortality, hospitalization and length of hospital stay were meta-analyzed and other patient outcomes were synthesized using a narrative approach. Results: The literature search identified 50 studies, representing 43 RCTs, comparing the use of CHITs with usual care for HF patients. The meta-analysis showed that the use of CHITs reduced the risk of HF-caused mortality (relative risk (RR) = 0.70, 95% confidence interval (CI): 0.54–0.91), p = 0.007), lowered the risk of HF-caused hospitalization (RR = 0.80, 95% CI: 0.66–0.96), p = 0.020), and shortened HF-caused length of hospital stay (mean difference = –0.52, 95% CI: –0.77 to –0.27, p < 0.00), but not all-cause mortality, all-cause hospitalization or all-cause length of hospital stay, compared with usual care. The narrative synthesis indicated that only a small proportion of the trials reported positive effects of CHITs over usual care. Conclusions: Evidence from RCTs presents mixed results on the impacts of CHITs for HF management. Further studies are required to assess whether and how CHITs would play a role in enhancing health care and patient outcomes and what specific CHIT features and functions are relevant to different HF treatment goals and self-care objectives.