Digital therapeutics for cardiovascular diseases in India- a low-middle income country’s perspective: a systematic review

Authors

  • Ashwin Prabhughate Lupin Digital Health, Mumbai, Maharashtra, India
  • Chetan Gharat Lupin Digital Health, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241561

Keywords:

Cardiac rehabilitation, Cardiovascular diseases, Digital medicine, M-health, Telemedicine

Abstract

Cardiovascular disease acts as a predominant cause for death in India. Digital technology has shown great potential in delivering cardiac rehabilitation remotely to patients with minimal cost implications. The main aim of this study was to analyze the comprehensiveness and effectiveness of digital cardiac rehabilitation intervention for cardiovascular patients on the Indian Cardiology Continuum. A comprehensive literature search was performed in Pubmed, Springer-link, Elsevier, Embase and Google Scholar. The selected tenure for this review was 10 years (16 January 2014 to 16 January 2024). Authors separately conducted the assessment of the selected studies by using the quality assessment of diagnostic accuracy studies. Microsoft excel 2020 was used for statistical analysis and graphical designs. A total of 3 articles were included in the review. The median sample size of the included studies is 153 (30-304), mean study timeline is 7.67 months (3-17), and median follow-up period is 6 months (3-12). Digital therapeutics showed significant reduction in Systolic Blood Pressure (34.67 mmHg) and Diastolic Blood Pressure (21.97 mmHg) in stage III hypertensive patients. Medication adherence of patients using digital therapeutics was 90%, while 10% patients remained non-adherent/dropped out of the trial. Digital therapeutics builds a lucrative bridge to help cardiovascular patients cross over into improved QoL, in place of traditional face-to-face CR regimes. Further research is required to improve comprehensiveness and clinical effectiveness of the digital cardiac rehab programs on a long-term basis in India.

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References

Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et alvascular Diseases Writing Group. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982-3021.

Reddy SK, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet. 2005;366(9498):1744-9.

Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K, et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA. 2007;297(3):286-94.

Babu AS, Veluswamy SK, Contractor A. Barriers to cardiac rehabilitation in India. J Prev Cardiol. 2016;5(3):871-6.

Kebapci A, Ozkaynak M, Lareau SC. Effects of eHealth-Based Interventions on Adherence to Components of Cardiac Rehabilitation: A Systematic Review. J Cardiovasc Nurs. 2020;35(1):74-85.

Salzwedel A, Jensen K, Rauch B, Doherty P, Metzendorf MI, Hackbusch M, et al. Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine: Update of the Cardiac Rehabilitation Outcome Study (CROS-II). Eur J Prev Cardiol. 2020;27(16):1756-74.

Chindhy S, Taub PR, Lavie CJ, Shen J. Current challenges in cardiac rehabilitation: strategies to overcome social factors and attendance barriers. Expert Rev Cardiovasc Ther. 2020;18(11):777-89.

Taylor RS, Dalal HM, McDonagh STJ. The role of cardiac rehabilitation in improving cardiovascular outcomes. Nat Rev Cardiol. 2022;19(3):180-94.

Bozkurt B, Fonarow GC, Goldberg LR, Guglin M, Josephson RA, Forman DE, et al. Cardiac Rehabilitation for Patients With Heart Failure: JACC Expert Panel. J Am Coll Cardiol. 2021;77(11):1454-69.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Int J Surg. 2021;88:105906.

Wongvibulsin S, Habeos EE, Huynh PP, Xun H, Shan R, Porosnicu Rodriguez KA, et al. Digital Health Interventions for Cardiac Rehabilitation: Systematic Literature Review. J Med Internet Res. 2021;23(2):e18773.

Zhang X, Luo Z, Yang M, Huang W, Yu P. Efficacy and safety of digital therapeutics-based cardiac rehabilitation in heart failure patients: a systematic review. ESC Heart Fail. 2022;9(6):3751-60.

Popovici M, Ursoniu S, Feier H, Mocan M, Tomulescu OMG, Kundnani NR, et al. Benefits of Using Smartphones and Other Digital Methods in Achieving Better Cardiac Rehabilitation Goals: A Systematic Review and Meta-Analysis. Med Sci Monit. 2023;29:e939132.

Popovici M, Ursoniu S, Feier H, Mocan M, Tomulescu OMG, Kundnani NR, et al. Benefits of Using Smartphones and Other Digital Methods in Achieving Better Cardiac Rehabilitation Goals: A Systematic Review and Meta-Analysis. Med Sci Monit. 2023;29:e939132.

Patil S, Kalashetti S, Kokane H, Somalaram V, Kaur A, Gupta V. Prospective evaluation of digital therapeutic intervention on blood pressure control in Indian patients with uncontrolled primary hypertension. European Heart J. 2023;44(1):779.

Palshikar A, Gharat CH, Patel K. A real-world evidence study to evaluate the efficacy of software-driven digital therapeutics on major adverse cardiovascular events, vitals, adherence to medication and lifestyle changes among patients with coronary artery disease or post-coronary interventions. Int J Res Med Sci. 2023;11:1541-8.

Anand SS, Samaan Z, Middleton C, Irvine J, Desai D, Schulze KM, et al. A Digital Health Intervention to Lower Cardiovascular Risk: A Randomized Clinical Trial. JAMA Cardiol. 2016;1(5):601-6.

Babu AS, Maiya AG, George MM, Padmakumar R, Guddattu V. Effects of Combined Early In-Patient Cardiac Rehabilitation and Structured Home-based Program on Function among Patients with Congestive Heart Failure: A Randomized Controlled Trial. Heart Views. 2011;12(3):99-103.

Rajendran AJ, Manoj S, Karthikeyan D, Davis S. Cardiac rehabilitation for CABG patients in South Indian setup: a prospective study. IJPMR. 2004;15:23-33.

Kunjan K, Thakur JS, Vijayvergiya R, Rohit MK, Kohli A, Oh P, et al. Effectiveness of cardiac rehabilitation in patients with myocardial infarction and percutaneous coronary intervention at a tertiary care hospital: A pilot intervention study. Int J Non-commun Dis. 2018;3(3):104-10.

Shrestha R, Singh JP, Shrestha K, Shrestha S. Cardiac rehabilitation knowledge among coronary artery disease patients attending a tertiary level hospital, Bharatpur. Hindu. 2020;67:78-8.

Prabhakaran D, Chandrasekaran AM, Singh K, Mohan B, Chattopadhyay K, Chadha DS, et al. Yoga-Based Cardiac Rehabilitation After Acute Myocardial Infarction: A Randomized Trial. J Am Coll Cardiol. 2020;75(13):1551-61.

Thomas RJ, Beatty AL, Beckie TM, Brewer LC, Brown TM, Forman DE, et al. Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019;140(1):e69-89.

Kissel CK, Nikoletou D. Cardiac Rehabilitation and Exercise Prescription in Symptomatic Patients with Non-Obstructive Coronary Artery Disease-a Systematic Review. Curr Treat Options Cardiovasc Med. 2018;20(9):78.

Chockalingam P, Natarajan V, Sekar T, Chockalingam A. Home-based cardiac rehabilitation to address evolving patient needs during the covid-19 pandemic. J Hong Kong College Cardiol. 2020;90.

Shanmugasegaram S, Perez-Terzic C, Jiang X, Grace SL. Cardiac rehabilitation services in low- and middle-income countries: a scoping review. J Cardiovasc Nurs. 2014;29(5):454-63.

Salvi D, Ottaviano M, Muuraiskangas S, Martínez-Romero A, Vera-Muñoz C, Triantafyllidis A, et al. An m-Health system for education and motivation in cardiac rehabilitation: the experience of HeartCycle guided exercise. J Telemed Telecare. 2018;24(4):303-16.

Sodhi N, Weinstein RS, Stewart K, Doarn CR. Analysis of Telehealth Versus Telemedicine Terminology in the Telemedicine and e-Health Journal Between 2010 and 2020. Telemed J E Health. 2022;28(12):1861-5.

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Published

2024-05-31

How to Cite

Prabhughate, A., & Gharat, C. (2024). Digital therapeutics for cardiovascular diseases in India- a low-middle income country’s perspective: a systematic review. International Journal of Research in Medical Sciences, 12(6), 2071–2078. https://doi.org/10.18203/2320-6012.ijrms20241561

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Section

Systematic Reviews