The impact of digital health on hospitalization and mortality in heart failure patients in low- and middle-income countries: a systematic review and meta-analysis.

Preston Nicely, Emily Eichstaedt, Charles Heald, Jack Simmons, Shiv Ishpujani, Stephen Clarkson

Abstract read

In one paragraph

Article in European heart journal. Digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Preston NicelyDepartment of Internal Medicine, The University of Alabama Birmingham, Medical Towers, MT 621, 1720 2nd Avenue South, Birmingham, AL 35294-4410, USA.ORCID https://orcid.org/0000-0002-0374-6612

Emily EichstaedtHeersink School of Medicine, The University of Alabama Birmingham, 701 19th Street South, ALGEN 7, Birmingham, AL 35233, USA.

Charles HealdDepartment of Internal Medicine, The University of Alabama Birmingham, Medical Towers, MT 621, 1720 2nd Avenue South, Birmingham, AL 35294-4410, USA.

Jack SimmonsDepartment of Internal Medicine, The University of Alabama Birmingham, Medical Towers, MT 621, 1720 2nd Avenue South, Birmingham, AL 35294-4410, USA.

Shiv IshpujaniDepartment of Internal Medicine, The University of Alabama Birmingham, Medical Towers, MT 621, 1720 2nd Avenue South, Birmingham, AL 35294-4410, USA.

Stephen ClarksonDivision of Cardiovascular Disease, The University of Alabama Birmingham, Tinsley Harrison Tower, Suite 311, 1900 University Boulevard, Birmingham, AL 35233, USA.ORCID https://orcid.org/0000-0002-7923-9676

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim: Heart disease is the leading cause of death worldwide, and the growing prevalence of heart failure (HF) is a key contributor. Digital health (dHealth) modalities including mobile applications, telehealth, and wearables have been developed to improve HF care, though little is known about their impact in low- and middle-income countries (LMICs). The aim of this review is to identify studies from LMICs that evaluated dHealth interventions for HF and determine the impact of those interventions on hospitalization and mortality. Methods and results: Six databases were searched from 1 January 1990 to 11 June 2025. A total of 3524 articles were screened (Cohen's κ = 69%). Included studies had a dHealth intervention, were a randomized controlled trial (RCT), occurred in a LMIC, and reported outcomes of interest. Risk of bias for RCTs was assessed using the Cochrane Risk of Bias 2 Tool. Fifteen RCTs ( Conclusion: Digital health in LMICs lowers hospitalizations and may reduce all-cause mortality, though the benefit for HF mortality remains uncertain. These findings support broader dHealth adoption in LMICs to address HF burden.PROSPERO registration number: CRD420251079715.

Indexed as

Digital healthHeart failureLow- and middle-income countriesmHealthMonitoringTelehealth

Identifiers

PMID42568654

DOI10.1093/ehjdh/ztag117

PMCPMC13447851

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.