Effectiveness of digital health interventions for care integration in coronary artery disease: a systematic review and meta-analysis
Allegra Chan, Hooi Min Lim, Woei Xian Lim, Jia Ting Leong, Adina Abdullah, Adam G DunnStructured Abstract
Aim
To assess the effectiveness of digital health interventions (DHIs) supporting care integration for coronary artery disease (CAD) in improving health outcomes compared to usual care.
Methods
For this systematic review, we searched MEDLINE, CINAHL, EBSCO Psychology and Behavioural Sciences Collection, Scopus, and Web of Science from 1 January 1995 to 5 November 2025. We included studies reporting primary data on DHIs supporting care integration for patients with CAD. Primary endpoints were all-cause mortality and readmissions, and CVD events. Secondary endpoints were the control of cardiovascular risk factors. We conducted random-effects meta-analyses in RevMan and assessed risk of bias with Cochrane’s RoB tools.
Results
We included 72 studies (23,111 participants), assessing 45 in the meta-analysis. All DHIs supported person-centred care integration (n=72) while few DHIs addressed clinical care integration (n=22), professional integration (n=12) and functional integration (n=22). Compared to usual care, DHIs supporting care integration had significant reductions in the odds of CVD events (OR: 0.74 [0.59, 0.92], df=5, p=0.02), but not in all-cause mortality or readmissions.
Conclusions
Although this review shows that DHIs supporting care integration were associated with reduced CVD events compared to usual care, the current evidence remains concentrated primarily on person-centred care integration, with limited studies evaluating broader dimensions of care integration at organisational and systemic levels. These findings highlight the important evidence gaps of DHIs in supporting more comprehensive and system-level integration in cardiovascular care. Further research is necessary to understand the influence of DHI modality and function on effectiveness of care integration.