Effectiveness of Behavior Change Techniques in EHealth-based Cardiac Rehabilitation in Patients with Coronary Artery Disease: A Systematic Review: Effective Behavior Change Techniques in EHealth CR

Overview

Journal Am J Prev Cardiol

Specialty Cardiology & Vascular Diseases

Date 2024 Dec 5

PMID 39634780

Authors

Emma R Douma

Tom Roovers

Mirela Habibovic

Gert-Jan de Bruijn

Jos A Bosch

Boris Schmitz

Willem J Kop

Affiliations

Soon will be listed here.

Abstract

Background: Participation in cardiac rehabilitation (CR) reduces risk of cardiovascular mortality, improves functional capacity and enhances quality of life in patients with coronary artery disease (CAD). eHealth-based CR can increase participation rates, but research into effective components is necessary. The objective of this systematic review was to identify effective behavior change techniques (BCTs) used in eHealth-based CR interventions.

Methods: A search of four databases (CINAHL, PubMed, PsychINFO, and MEDLINE) was conducted until January 10, 2023. Randomized controlled trials investigating eHealth-based interventions for patients with CAD were included. Risk of bias was assessed using the Effective Public Healthcare Practice Project tool. BCTs were coded following the Behavior Change Taxonomy. A best-evidence synthesis was conducted to determine the effectiveness of BCTs, with ratings ranging from A (strong evidence indicating either a positive effect (+) or no effect (-)) to D (no data collected).

Results: A total of 88 studies (25,007 participants) met the eligibility criteria. The interventions in these studies used 31 different BCTs. The most common BCTs were (k = 86), (k = 69) and and information about health consequences (k = 56). The evidence for was rated as A+ for medication adherence and diet. Conversely, for systematically decreasing the number of prompts/cues sent during an intervention, the evidence was rated as A- for physical activity, medication adherence and smoking cessation. The evidence for was rated as A+ for medication adherence and A- for smoking cessation.

Conclusions: Action planning is effective as a BCT in eHealth-based CR, whereas reducing prompts/cues is not. may, depending on the behavior targeted, exert both positive and no effect, suggesting that BCT-behavior matching is important to optimize effectiveness of eHealth-based CR.

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