Effect of telemedicine on the quality of life of people with heart disease: a systematic review

Alves, Gabriele Cardoso Gonçalves; Amador, Fabiola Leticia Damascena; Santos, Vagner Rogério dos; Moreira, Rita Simone Lopes

doi:10.1590/1518-8345.7243.4566

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Review Article • Rev. Latino-Am. Enfermagem 33 • 2025 • https://doi.org/10.1590/1518-8345.7243.4566 linkcopy

Effect of telemedicine on the quality of life of people with heart disease: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: to synthesize the scientific evidence on the effectiveness of telemedicine-based interventions in improving health-related quality of life and self-management of patients with heart disease.

Method: systematic review of effectiveness, following the recommendations of the Joanna Briggs Institute and the reporting guideline Preferred Reporting Items for Systematic Reviews and Meta-Analyses Checklist. The search was conducted in six databases: Cochrane Library, Virtual Health Library, PubMed, CINAHL, Web of Science Core Collection and Scopus, without period restriction, in English, Portuguese or Spanish. The methodological quality and risk of bias of the studies were assessed using the JBI critical appraisal tool and the certainty of the evidence was classified using the GRADE tool.

Results: of the 44 randomized clinical trials included, the main interventions analyzed were telemonitoring, telephone contact and telerehabilitation. Out of the studies evaluated, 88.63% demonstrated an improvement in health-related quality of life, with 45.45% of these showing a statistically significant difference.

Conclusion: telemedicine shows promise as a valuable tool for the care and self-management of individuals with cardiac conditions. However, further studies are needed to confirm its effectiveness and impact on health outcomes.

Descriptors:
Telemedicine; Heart Diseases; Self-Management; Quality of Life; Telerehabilitation; Self Care

Highlights:

(1) The main resources observed were: telemonitoring, tele-connection and telerehabilitation. (2) Telemedicine can be an effective tool in the care of cardiac conditions. (3) The real impact on quality of life in cardiac diseases is still uncertain. (4) Studies related to aspects of quality of life are still needed.

Author, year, country	Population, n, follow-up	Intervention	Resources	Comparation	Main outcomes	Main results
Choi, et al. ( ³¹ ) 2023 Korea	Individuals diagnosed with HF* n:76 (CG ^†: 38\| IG ^‡: 38) Follow-up: 3 months	Self-management program via mobile application (“Heart Failure-Smart Life”)	“Heart Failure-Smart Life” app: Educational content One-on-one chat with healthcare professional Daily health records for personalized and interactive monitoring, with features tailored to individual needs Self-management feedback from nurse Distinct app for healthcare professionals	Usual care: consultations with a cardiologist and cardiology nurse; brief information about medications and the progression of the disease	Anthropometric measurements; NYHA functional classification ^§ Depression (Geriatric Depression scale) HRQoL ^\|\| (MacNew Heart Disease Health-Related QoL) Medication adherence (Hill-Bone Medication Adherence) Self-care (European Heart Failure Self-Care Behaviour Scale)	In the comparison between groups, there were significant improvements in the NYHA ^§ functional class (p = 0.003) in IG ^‡ . HRQoL ^\|\| showed no significant differences between the groups (CG ^† =5.34; IG ^‡ =5.62). Self-care behavior improved over time (p < 0.001), but without significant differences between the groups.
Dalli Peydró, et al. ( ³² ) 2022 Spain	Individuals after hospital discharge due to ACS ^¶ n: 59 (CG ^†: 28 \| IG ^‡: 31) Follow-up: 10 months	Telerehabilitation, preceded by in-hospital training for 2 weeks, after adjustments to pace and goals, the app guided participants through a daily exercise program	App: Daily physical activity program General health record Vital signs Medication adherence HR** monitor	Center-based cardiac rehabilitation	Increased reported physical activity (International Physical Activity Questionnaire) VO ₂ ^†† max HRQoL ^\|\| (EQ-5D ^‡‡ 5-levels)	The IG ^‡ showed a greater increase in physical activity (1,726 vs. 636 multiples of metabolic equivalents -min/week, p = 0.045) and VO ₂ ^†† max (1.62 vs. 0.60 ml/kg min), p < 0.004). Adherence to the Mediterranean diet, psychological distress and HRQoL ^\|\| showed greater improvement in the IG ^‡ than in the CG ^† . Self-rated health improved in both groups, but was only significant in the IG ^‡ (p = 0.008)
Chow, et al. ( ³³ ) 2022 Australia	Individuals diagnosed with SCA¶ n:1424 (CG ^†: 708\| IG ^‡: 716) Follow-up: 12 months	Personalized SMS ^§§ program aimed at improving medication adherence and secondary prevention	Sending motivational and educational SMS ^§§ divided into three main modules: lifestyle (diet, exercise, smoking cessation), medications (information on use and side effects), general secondary prevention (health goals, mental health support and health services) Health advisor	Usual care was not described	Self-reported medication adherence Anthropometric and laboratory measurements HRQoL ^\|\| (SF ^\|\|\|\| -12)	There was no significant difference in self-reported medication adherence between IG ^‡ and CG ^† 0.93 [95% confidence interval, 0.84–1.03]; P=0.15). There was no difference in depression and anxiety scores, but there was a slight improvement in HRQoL ^§ (physical component) score for IG ^‡ (mean difference [95% confidence interval], 1.1 [0.0, 2.2]; P=0.045).
Voller, et al. ( ³⁴ ) 2022 Germany	Individuals diagnosed with HF* n:621 (CG ^†: 319 \| IG ^‡: 302) Follow-up: 12 months	Home telemonitoring via the Motiva ^® system, which enables patients to manage their health condition and facilitates daily contact between doctors and patients	Motiva ^® System Regular recording of vital parameters (BP ^¶¶ , HR** and weight) Educational material, training material, questionnaires, reminders and feedback on health status via Motiva ^® Telephone monitoring of possible decompensations	Usual care, based on the guidelines of the European Society of Cardiology	Incremental cost-effectiveness Mortality HRQoL ^\|\| (SF ^\|\|\|\| -36 V2; WHO-5***; KCCQ ^††† ) Functional capacity	The intervention had no impact on mortality risk. All HRQoL scales improved consistently and significantly in the IG ^‡ at 12 months compared to the CG ^† (all p < 0.01)
Brouwers, et al. ( ³⁵ ) 2021 Netherlands	Individuals in rehabilitation (phase 2) for CAD ^‡‡‡ n: 300 CG ^†: 147 \| IG ^‡: 153) Follow-up: 12 months	Telerehabilitation, whose program included 6 group exercise sessions, weekly video consultations carried out by physiotherapists until the completion of individual or program goals, in addition to weekly telemonitoring	App: Vital signs monitoring HR monitor** Accelerometer Physical training module Weekly video consultations	Center-based cardiac rehabilitation	HRQOL ^\|\| (EQ-5D ^‡‡ 5-levels; EQ-VAS ^§§§ ; MacNew Heart Disease Health-Related Quality of Life Questionnaire) Healthcare costs	Patients in IG ^‡ and CG ^† had comparable HRQoL ^\|\| (mean difference in EQ-5D-5L ^‡‡: −0.004; p = 0.82; mean difference in EQ-VAS ^§§§: −0.001). Although intervention costs were higher, there were no differences in total cardiac healthcare costs between the two groups (€4,787 vs. €5,507, p = 0.36)
Maddison, et al. ( ³⁶ ) 2021 New Zealand	Adults with SCA ^¶ n:306 (CG ^†: 153\| IG ^‡: 153) Follow-up: 13 months	Automated SMS ^§§ program called Text 4 HartII, promoting self-management and health education	Sending personalized SMS ^§§ Telephone calls to administer questionnaires	Usual outpatient care, without details	Medication adherence (Morisky Medication Adherence Scale) HRQoL ^\|\| (EQ-5D ^‡‡ )	Medication adherence in three classes was lower in the IG ^‡ compared with the CG ^† , both at 24 weeks (56.8% vs 68.6%) and at 52 weeks (67.9% vs 54.2%). Self-reported medication adherence scores reflected this trend at 52 weeks
Collins, et al. ( ³⁷ ) 2021 The United States of America	Individuals diagnosed with HF* n:491 (CG ^†: 245 \| IG ^‡: 246) Follow-up: 12 months	Usual care and personalized discharge plan, telephone self-care coaching, with intervention consisting of home visit within 7 days of discharge and telephone self-care training	Telephone calls Telehealth consultation	Usual care consisting of a structured discharge process, including reconciliation and medication prescription; and medical consultation for follow-up	Death associated with cardiovascular disease Events related to HF* HRQoL ^\|\| (KCCQ ^††† )	There was no significant difference between the groups in mortality, HF-related events*, and changes in KCCQ ^††† summary score at 90 days. Although the KCCQ ^††† summary score was higher in the IG ^‡ , the difference was not statistically significant (95% confidence interval -1.9 to 7.2; P = 0.25)
Clays, et al. ( ³⁸ ) 2021 Belgium and Italy	Individuals diagnosed with HF* n:56 (CG ^†: 22 \| IG ^‡: 34) Follow-up: 6 months	Home telemonitoring system consisting of a combination of monitoring devices and a mobile application, designed to provide comprehensive support for patient health management	HeartMan System: Wearable HR** and BP monitor ^¶¶ Scale Pill organizer Smartphone with HeartMan mobile app, with features for physical management, psychological support and HF* education Operational telephone support service	Usual care with standard treatment according to clinical guidelines provided by the cardiologist, general practitioner and IC nurse*	HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| ) Exercise capacity (6MWT ^¶¶¶ ) Perception of illness and mental health (Brief Illness Perception. Questionnaire) Self-care (Self-Care of Heart Failure Index)	In IG ^‡ , there was a significant reduction in depression and anxiety (p < 0.001), while in CG ^† the need for sexual counseling decreased (p < 0.05). Only in IG ^‡ , self-care increased (p < 0.05) and sexual problems decreased (p < 0.05), but there was no significant impact on HRQoL ^\|\| confidence in self-care, perception of illness or exercise capacity between the groups.
Batalik, et al. ( ³⁹ ) 2020 Czech Republic	Individuals with cardiovascular disease undergoing cardiac revascularization n: 56 (CG ^†: 28 \| IG ^‡: 28) Follow-up: 3 months	Telerehabilitation, preceded by supervised outpatient training	App: Vital signs monitoring HR** monitor Physical training module Weekly telephone reassessment	Center-based cardiac rehabilitation	Physical fitness (Cardiopulmonary Exercise Test) HRQoL ^\|\| (SF ^\|\|\|\| -36) Adherence to training	Both groups showed significant improvements in physical fitness (P < 0.001), with similar adherence between them. HRQoL ^\|\| improved significantly in both groups, with no significant difference between them (P < 0.01)
Lunde, et al. ( ⁴⁰ ) 2020 Norway	Individuals undergoing rehabilitation (phase 2) for CAD ^‡‡‡ n: 300 CG ^†: 147 \|IG ^‡: 153) Follow-up: 12 months	Individualized monitoring via app, with goal setting, reminders, progress assessment and personalized feedback	App: Behavioral guidelines (physical activity and diet) Healthy habits Setting individual goals Reminders Individual feedback	Usual care was not detailed	Difference in peak VO ₂ ^†† Exercise performance Body weight Resting BP ^†† Exercise habits HRQoL ^† (HeartQoL****) Health status (EQ-5D ^‡‡ 5-levels)	In IG ^‡ , there was a significant difference in peak VO ₂ ^†† compared to CG ^† (mean difference of 2.2 ml/kg/min, 95% confidence interval 0.9–3.5, p = 0.001). In addition, IG ^‡ showed better exercise performance, exercise habits and self-perception of goal achievement, compared to CG ^† . No significant differences were found between the groups in blood pressure, HRQoL ^\|\| and health status.
Piotrowicz, et al. ( ⁴¹ ) 2020 Poland	Individuals diagnosed with HF* n:850 (CG ^†: 425\|IG ^‡: 425) Follow-up: 14 to 26 months	Telerehabilitation started with hospital training, followed by home training. It included medical supervision, education, and personalized exercise planning for each patient.	Monitoring center, with cell phone availability for: Recording of vital signs and clinical data Individualized physical training Educational program Portable ECG ^†††† BP monitor ^¶¶ Scale Cardioverter defibrillator monitor (only for patients with the implant)	Usual care included regular clinical assessments, participation in rehabilitation programs, remote monitoring of implantable cardiac devices, and advice on lifestyle changes and self-management according to standard clinical guidelines.	Percentage of out-of-hospital survival Mortality Change in cardiopulmonary exercise test duration HRQoL ^\|\| (SF ^\|\|\|\| -36)	There were no significant differences in mortality rate (12.5% vs 12.4%, respectively; hazard ratio, 1.03 [95% confidence interval, 0.70-1.51]) or hospitalization (mean [SD] days, 91.9 [19.3] vs 92.8 [18.3], respectively; P = .74) between groups. However, IG ^‡ showed significant benefits in terms of improved maximal oxygen uptake and HRQoL ^\|\| (SF score ^\|\|\|\| -36, 1.58 [95% confidence interval, 0.74-2.42] vs 0.00 [95% confidence interval, -0.84 to 0.84]; P = .008), and it was well tolerated with no serious adverse events during exercise.
Ávila, et al. ( ⁴² ) 2020 Belgium	Individuals with CAD ^‡‡‡ n:90 (CG ^† usual care:30 \| CG ^† rehabilitation:30 \| IG ^‡: 30) Follow-up: 3 months	Telerehabilitation program associated with telemonitoring and individualized exercise prescription	App Wearable (watch) Feedback by phone or email	Center-based rehabilitation with outpatient training Usual care: encouraged to maintain a physically active lifestyle and invited for follow-up appointments	Cardiorespiratory fitness (VO ^2†† peak). Physical activity Traditional cardiovascular risk factors HRQoL ^\|\| (SF ^\|\|\|\| -36)	All groups maintained high scores for all HRQoL ^\|\| parameters, with no significant differences between groups (p = 0.70). Exercise capacity and secondary outcomes were preserved in all three groups over time (p > 0.05 for all), regardless of intervention (p > 0.05 for all).
Cáceres, et al. ( ⁴³ ) 2020 The United States of America	Individuals diagnosed with AF ^‡‡‡‡ or Atrial Flutter n:238 (CG ^†: 123\|IG ^‡: 115) Follow-up: 6 months	iHEART intervention for telemonitoring and guidance via SMS ^§§	Use of iPhone with AliveCor ^® Kardia mobile ECG ^†††† system for remote cardiac monitoring Sending SMS ^§§ with guidance on AF management ^‡‡‡‡ and lifestyle.	Usual care with standard treatment in accordance with current guidelines	AF recurrence ^‡‡‡‡ HRQoL ^\|\| (SF ^\|\|\|\| -36; EQ-5D-5L ^‡‡ ; Atrial Fibrillation Effect on Quality of Life) AF symptom severity ^‡‡‡‡ (Atrial Fibrillation Severity Scale)	Improvement in both groups from baseline to follow-up in AF Effect Scale scores ^‡‡‡‡ on HRQoL ^\|\| (p < 0.05), with greater impact in IG ^‡ . There were no statistically significant differences in HRQoL ^\|\| or severity of AF symptoms ^‡‡‡‡ between groups.
Cichosz, et al. ( ⁴⁴ ) 2019 Denmark	Individuals diagnosed with HF* n:299 (CG ^†: 154\|IG ^‡: 145) Follow-up: 12 months	Telekits intervention, with a central clinical system that included vital signs monitoring, nursing assessment, telephone contacts for management and referral to medical appointments, if necessary	Tablets Digital BP ^¶¶ monitors Scales Telephone contact	Rehabilitation, dietary counseling, coaching, medication monitoring, risk factor screening, and lifestyle change discussions	HRQoL ^\|\| (SF ^\|\|\|\| -36): physical and mental score HF*-specific questionnaire score (KCCQ ^††† )	The IG ^‡ showed significant improvement in mental scores compared to the CG ^† (p < 0.01). There was no significant effect on the improvement of the physical score (SF ^\|\|\|\| -36) or on the quality of life related to HF* (KCCQ ^††† )
Mizukawa, et al. ( ⁴⁵ ) 2019 Japan	Individuals diagnosed with HF* n: 59 (CG ^†: 19\| IG ^‡ 1:20\| IG ^‡ 2: 20) IG ^‡ 1: Collaborative management IG ^‡ 2: Education for self-management Follow-up: 24 months	Monitoring and self-management system, with daily recording of vital signs, doctor visits, monthly self-management education sessions and remote telephone monitoring by a nurse for the IG ^‡1	HR** monitor BP ^¶¶ monitor Weight monitoring Educational intervention Telephone management via nurse, only for IG ^‡1	Physician visits every 2-4 weeks, an education session at discharge, and guidance on daily recording of weight, BP ^¶¶ , and pulse in a self-management notebook	HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| ) Self-efficacy (Chronic Disease Self-Efficacy Scale) Self-care (European Heart Failure Self-care Behaviour ScaleS) Readmission due to HF* All-cause mortality	HRQoL ^\|\| significantly improved in the IG ^‡1 group compared with the CG ^† at 18 and 24 months (P < 0.05). The IG ^‡1 group also showed significant improvements in self-efficacy and self-care (P < 0.01), and had lower rates of rehospitalization (20.0% vs. 57.9% in the CG ^† ) with greater survival without readmission (P = 0.020).
Pekmezaris, et al. ( ⁴⁶ ) 2019 The United States of America	Black and Hispanic individuals from underserved communities with a primary diagnosis of HF* n: 104 (CG ^†: 58 \| IG ^‡: 46) Follow-up: 3 months	Self-monitoring via telehealth, focused on daily self-management and weekly telehealth visits with intensive and continuous support from a nurse	HR** monitor BP ^¶¶ monitor Weight monitoring Oxygen saturation monitor Weekly video consultation with a nurse	Comprehensive outpatient management based on usual care in an outpatient setting, with adherence to American Heart Association guidelines	Hospitalization and emergency service utilization HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| ) Anxiety and depression (Patient Health Questionnaire -4)	The results indicated that there was no significant difference between IG ^‡ and CG ^† in emergency room visits (Relative Risk = 1.37, confidence interval = 0.83–2.27), hospitalizations (Relative Risk = 0.92, confidence interval = 0.57–1.48) or length of hospital stay (IG ^‡ = 0.54 vs. CG ^† = 0.91). Both groups had an increase in HRQoL ^\|\| values, with no statistical differences
Peng, et al. ( ⁴⁷ ) 2018 China	Individuals diagnosed with HF* and their caregivers n:98 (CG ^†: 49 \| IG ^‡: 49) Follow-up: 4 months	Telerehabilitation, a telehealth physical training program with exercise sessions monitored by physiotherapists and regular follow-up by cardiac nurses via telephone or SMS ^§§	Telehealth fitness training program Educational brochure Exercise sessions, with video supervision Follow-up with nurses via phone calls or instant messages (Wechat)	Usual care was based on an educational session at hospital discharge and regular follow-up visits to the clinic. Patients in this group did not receive specific instructions on physical exercise.	HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| ) Distance covered in the 6MWT ^¶¶¶ Physiological measures Anxiety and depression (Hospital Anxiety and Depression Scale)	The IG ^‡ demonstrated statistically significant improvements in HRQoL ^\|\| (Fb = 8.272, P = 0.005), with a maintenance up to 4 months after the post-test (Fin = 79.73, P = 0.000) and in the distance walked in the 6MWT ^¶¶¶ compared to the CG ^† in the post-test. No significant improvements were observed in relation to the other parameters
Wagenaar, et al. ( ⁴⁸ ) 2018 Netherlands	Individuals diagnosed with HF* n:450 (CG ^†: 150 \| IG ^‡ site:150 \| IG ^‡ e-Vita:150) Follow-up: 12 months	The intervention consisted of a website containing educational health content. In addition, IG ^‡ e-Vita participants followed an e-health care plan with telemonitoring and personalized adjustments.	Website Nursing guidelines e-Vita platform Regular recording of vital parameters (weight, BP ^¶¶ and HR**) Alerts triggered in case of values outside the pre-established limits Updates on comorbidities and medications Monthly reminders by email for monitoring and adherence to the care plan	Usual care from nine HF* outpatient teams, including routine consultations with a cardiologist and an HF* nurse, on average four times per year.	Patient self-care (European Heart Failure Self-Care Behavior Scale) HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| ) Disease-specific knowledge (Dutch Heart Failure knowledge Scale) Patient satisfaction with HF* care Mortality	After 3 months, IG ^‡ showed better self-care compared to CG ^† (IG ^‡ site 73.5 vs. 70.8 and IG ^‡ e-Vita 78.2 vs. 70.8, respectively). Furthermore, after 3 and 6 months, there were significant differences in HRQoL ^\|\| between IG ^‡ e-Vita and CG ^† (median IG ^‡ e-Vita 19.0 vs. CG ^† 22.8, p = 0.029 and IG ^‡ e-Vita 21.0 vs. CG ^† 24.0, p = 0.003), respectively. These differences diminished over time, with no differences after 1 year.
Guo, et al. ( ⁴⁹ ) 2017 China	Individuals with AF ^‡‡‡‡ n: 209 (CG ^†: 96 \| IG ^‡: 113) Follow-up: 3 months	Self-management system based on a mobile application, offering clinical decision support, educational programs, health monitoring, and structured follow-up	Clinical decision support application: Automatic calculation of risk scores Educational programs Self-care engagement components Structured follow-up components Personal health record	Usual care was not described	Patient knowledge about AF ^‡‡‡‡ HRQoL ^\|\| (EQ-5D ^‡‡ ) Medication adherence (Pharmacy Quality Alliance) Usability, feasibility and acceptability of the application	Over 90% of patients reported that the app was easy to use and useful, associated with significant improvements in knowledge (p < 0.05). Medication adherence and satisfaction with anticoagulants were significantly better in the IG ^‡ compared to the CG ^† (p < 0.05). HRQoL ^\|\| scores significantly improved with the app, with reductions in anxiety and depression (p < 0.05)
Hwang, et al. ( ⁵⁰ ) 2017 Australia	Individuals diagnosed with HF* n:53 (CG ^†: 29 \| IG ^‡: 24) Follow-up: 6 months	Telerehabilitation, with a program carried out twice a week with video consultations, supervision by a physiotherapist, real-time exercises and educational sessions and remote support	Telerehabilitation via video consultation platform Interaction between the physiotherapist and participants, feedback and modifications of therapeutic plans Educational slides with embedded audio files Online group discussions Collaborative design Chat functions Equipment manual with written and pictorial instructions	Traditional center-based rehabilitation	HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| ; ^‡‡ EQ-5D) Distance covered in the 6MWT ^¶¶¶ Satisfaction (Client Satisfaction Questionnaire) Rate of adverse events	The analyses revealed no significant differences between the groups regarding HRQoL ^\|\| , indicating a similarity in the results. Both groups showed statistically significant improvements in their HRQoL ^\|\| , which were maintained during the follow-up period. Regarding the distance covered in the 6MWT ^¶¶¶ , no significant differences were observed between the groups, with a mean difference of 15 meters (95% confidence interval –28 to 59).
Jayaram, et al. ( ⁵¹ ) 2017 The United States of America	Individuals diagnosed with HF* n:1521 (CG ^†: 765 \| IG ^‡: 756) Follow-up: 6 months	Tele-HF telemonitoring program based on telephone calls	Educational materials Scale Daily phone calls with questionnaires Medical feedback, if needed Reminders	Usual care was not detailed, cited as standard recommendations from guidelines for the treatment of HF*, with educational materials and provision of a scale if necessary	HRQoL ^\|\| (KCCQ ^††† )	During the 6-month follow-up, patients in IG ^‡ had a mean overall KCCQ ^††† summary score 2.5 points higher (95% confidence interval = 0.38, 4.67; p = 0.02) than those receiving usual care. This difference was driven primarily by improvements in symptoms (3.5 points; 95% confidence interval = 1.18, 5.82; p = 0.003) and social functioning (3.1 points; 95% confidence interval = 0.30, 6.00; p = 0.03).
Piotrowicz, et al. ( ⁵² ) 2020 Poland	Individuals diagnosed with HF* n:111 (CG ^†: 34\| IG ^‡: 77) Follow-up: 2 months	Telerehabilitation program associated with telemonitoring and individualized exercise prescription, based on Nordic walking	Telerehabilitation and remote monitoring equipment: Mini EHO Device BP Monitor ^¶¶ Scale ECG ^†††† Cell phone Questionnaires Telephone support (psychological support and additional instructions)	Usual care, without formal prescription of physical training or supervised rehabilitation. Recommendations for lifestyle changes and self-management according to the European Society of Cardiology guidelines	Functional capacity (VO ₂ ^†† peak) HRQoL ^\|\| (SF ^\|\|\|\| -36) Extended assessment of rehabilitation effectiveness Safety and adherence to training	In IG ^‡ , a significant improvement in functional capacity was observed (p = 0.0001) with positive repercussions on HRQoL ^\|\| , without statistical differences. All participants completed the rehabilitation program, with high adherence to home Nordic walking training, with 94.7% of patients considered adherent
Bekelman, et al. ( ⁵³ ) 2015 The United States of America	Individuals diagnosed with HF* n:392 (CG ^†: 193\| IG ^‡: 199) Follow-up: 12 months	The Patient-Centered Disease Management Program combined multidisciplinary collaborative care, telemonitoring, and joint management of HF* and depression	Multidisciplinary collaborative care Screening and treatment of depression Telemonitoring and patient self-care support: BP ^¶¶ and HR** monitor Weight monitoring and self-reported symptoms Medication reminders Education material on HF* and depression Dietary counseling	Follow-up with usual care healthcare team, information at enrollment visit describing self-care for HF* and a scale if needed, physicians notified if depressive symptoms developed	HRQoL ^\|\| (KCCQ ^††† ) Depressive symptoms (PHQ-9 ^§§§§ ) Hospitalizations Mortality	There were no significant differences in baseline characteristics between the intervention and usual care groups. After 1 year, both groups showed similar improvement in KCCQ ^††† scores (mean change 13.5 points, p = 0.97). The intervention was associated with fewer deaths at 1 year (4.3% vs 9.6%, p = 0.04)
Frederix, et al. ( ⁵⁴ ) 2015 Belgium	Individuals with CAD ^‡‡‡ in cardiac rehabilitation or HF* n: 140 (CG ^†: 70 \| IG ^‡: 70) Follow-up: 6 months	Telerehabilitation, consisting of telemonitoring and telecoaching, added to the conventional 12-week center-based cardiac rehabilitation program.	Remote monitoring of physical activity Accelerometer Remote coaching via website Guidance on smoking cessation, diet and physical activity Feedback via email or SMS ^§§	Traditional center-based rehabilitation	Maximum aerobic capacity (VO ₂ ^†† peak) Daily physical activity Glycated hemoglobin, glycemic control and lipid profile HRQoL ^\|\| (HeartQoL****)	Patients in IG ^‡ showed a significant increase in mean peak VO ₂ ^†† from baseline (mean 22.46) to 24 weeks (mean 24.46, P<0.01), while in CG ^† there was no significant change. Furthermore, self-reported physical activity and global HRQoL ^\|\| score improved more in IG ^‡ compared to CG ^† at 24 weeks (P=0.01)
Maddison, et al. ( ⁵⁵ ) 2015 New Zealand	Individuals with ischemic heart disease n: 171 (CG ^†: 86 \| IG ^‡: 85) Follow-up: 6 months	HEART Program, which consisted of exercise prescription and behavioral support via SMS ^§§ and internet, aiming to increase physical activity in patients	Prescription of regular exercise Provision of behavior change strategies Website with information about the disease and possibility of self-monitoring of progress Daily SMS ^§§ sending	Usual care was not described	Maximal aerobic capacity (VO ₂ ^†† peak) Self-reported physical activity (International Physical Activity Questionnaire) Self-efficacy and motivation for exercise HRQoL ^\|\| (SF ^\|\|\|\| -36 version 2; EQ-5D ^‡‡ )	There was a significant increase in self-reported leisure-time physical activity (p = 0.05) and walking (p = 0.02) in IG ^‡ . There were also significant improvements in self-efficacy to be active and the general health domain of the SF ^\|\|\|\| -36 in IG ^‡ , with a difference of 2.1, 95% confidence interval: 0.1, 4.1; p = 0.03) at 24 weeks for HRQoL ^\|\|
Piotrowicz, et al. ( ⁵⁶ ) 2015 Poland	Individuals diagnosed with HF* n: 152 (CG ^†: 75 \| IG ^‡: 77) Follow-up: 2 months	Telerehabilitation, based on walking, using a telemonitoring system and supervised training	Telerehabilitation with pre-programmed training sessions for each individual Telemonitoring Sending of resting ECG ^†††† and answering a health questionnaire before physical activity Psychological support	Traditional center-based rehabilitation	HRQOL ^\|\| (SF ^\|\|\|\| -36)	Total HRQoL ^\|\| was improved in both groups, but was not significant. IG ^‡ had an improvement mainly in the mental categories and CG ^† improved their general physical well-being.
Kraal, et al. ( ⁵⁷ ) 2014 Netherlands	Individuals with CAD ^‡‡‡ who entered cardiac rehabilitation after hospitalization for AMI ^\|\|\|\|\|\|\|\| , unstable angina or revascularization (low to moderate risk) n: 55 (CG ^†: 26 \| IG ^‡: 29) Follow-up: 3 months	Telerehabilitation, which began with monitored training sessions, goal setting and motivational interviews, with telephone feedback from the physiotherapist	Telerehabilitation Telemonitoring with wearable HR monitor** App Feedback by phone	Traditional center-based rehabilitation	VO ₂ ^†† peak HRQoL (MacNew Heart Disease Health-Related QoL) Adherence to training	Significant improvement in peak VO ₂ ^†† consumption (CG ^†: 10% and GI ^‡: 14% respectively) in both groups, with no significant difference between groups. HRQoL ^\|\| improved significantly in both groups, with no differences between them.
Varnfield, et al. ( ⁵⁸ ) 2014 Australia	Individuals after AMI ^\|\|\|\|\|\|\|\| n: 120 (CG ^†: 60\| IG ^‡: 60) Follow-up: 6 months	Telerehabilitation via Cardiac Rehabilitation Care Assessment Platform (CAP-CR), based on exercise prescription and delivery of educational content	CAP-CR Platform: Health monitoring Exercise monitoring SMS ^§§ and audio files with motivational and educational content Web portal Weekly consultations with mentors	Traditional center-based rehabilitation	Adherence, adherence and completion of the cardiac rehabilitation program Biomedical risk factors (BP ^¶¶ , HR**, weight, among others) HRQoL ^\|\| (EQ-5D ^‡‡ )	The IG ^‡ had significantly higher adherence (80% vs 62%) and completion (80% vs 47%) rates than the CG ^† (p<0.05). Both groups improved significantly in the 6MWT ^¶¶¶ , which was maintained at 6 months. The IG ^‡ also showed positive effects on HRQoL ^\|\| (EQ-5D ^‡‡: median 0.84 to 0.92)
Blum, et al. ( ⁵⁹ ) 2014 The United States of America	Individuals diagnosed with HF* n: 206 (CG ^†: 102\|IG ^‡: 104) Follow-up: 12 months	Vital signs telemonitoring system, with nursing monitoring and patient contact Send feedback Translation results available	Philips Electronics E-care system for remote data monitoring; Scale BP ^¶¶ Monitor ECG ^††††	Easy access to routine specialist care, with outpatient appointments and access to telephone numbers as appropriate	HRQoL ^\|\| (SF ^\|\|\|\| -36; MLHFQ ^\|\|\|\|\|\| ) Medical costs Rehospitalization within 30 days Mortality	HRQoL ^\|\| scores in both groups improved over the year (p<0.001), but there was no significant difference between the groups. There were no differences in mortality (p=0.575), readmission rate (p=0.627), or payments for hospitalizations and emergency department visits between the groups.
Cui, et al. ( ⁶⁰ ) 2013 Canada	Individuals diagnosed with HF* n:174 (CG ^†: 55 \| IG ^‡ Telephone:61 \| IG ^‡ Telemonitoring:58) Follow-up: 12 months	Health Lines Program, consisting of: nursing care with health guidance for self-management and health education tools. In addition to home monitoring for IG ^‡ patients Telemonitoring	Nursing phone calls BP ^¶¶ monitors Scales Health education tools	Usual care was not described	Costs and health care HRQoL ^\|\| (SF ^\|\|\|\| -36) Self-care (Revised Self-Care Behavior scale) Satisfaction (Client Satisfaction Questionnaire)	Both interventions were more effective and less expensive than standard care. There was a significant improvement in self-care behavior and HRQoL ^\|\| (p<0.05), with statistically significant higher utility scores in the intervention groups.
Hawkes, et al. ( ⁶¹ ) 2012 Australia	Individuals diagnosed with AMI ^\|\|\|\|\|\|\|\| n:430 (CG ^†: 215 \| IG ^‡: 215) Follow-up: 6 months	Telephone coaching on managing heart disease risk factors “My Heart My Life” educational resource	Telemedicine or support telephone lines	“My Heart My Life” educational resource and informative physical newsletter every three months	HRQoL ^\|\| (SF ^\|\|\|\| -36) Physical activity (Active Australia Survey) Satisfaction Risk factors for heart disease	At 6 months, the IG ^‡ demonstrated higher HRQoL ^\|\| scores compared to the CG ^† in the mental (95% confidence interval 0.5 to 4.9; p = 0.02), physical (95% confidence interval 0.1 to 4.5; p = 0.04) and emotional (95% confidence interval 0.2 to 5.2; p = 0.03) components. In addition, the IG ^‡ were more likely to be sufficiently active (p = 0.02) and maintain a healthy weight (p = 0.05) compared to the CG ^† .
Seto, et al. ( ⁶² ) 2012 Canada	Individuals diagnosed with HF* n: 100 (CG ^†: 50 \| IG ^‡: 50) Follow-up: 6 months	Telemonitoring system and beyond standard service	Telemonitoring system: Daily weight and BP ^¶¶ and ECG ^†††† records Symptom questionnaire on cell phone Sending messages Website Reminder phone call Sending alert emails to the cardiologist Contacting the patient by phone	Regular care, including scheduled clinic visits and HF* education during appointments. They also had access to telephone support but did not receive study-specific interventions beyond this usual care	Brain natriuretic peptide levels Self-Care of Heart Failure Index HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| )	The IG ^‡ showed a significant improvement in HRQOL ^\|\| (p = 0.05), and greater maintenance of self-care (p = 0.03), compared to the CG ^† . Both groups had improvements in brain natriuretic peptide levels, self-care management, and ventricular ejection fraction.
Blasco, et al. ( ⁶³ ) 2012 Spain	SCA ^¶ survivors n: 203 (CG ^†: 101 \| IG ^‡: 102) Follow-up: 12 months	Telemonitoring and sending text messages with recommendations	Web app for sending text messages Mobile phone Sending recommendations via mobile phone BP monitor and glucometer	Three consultations with a cardiologist; written and verbal recommendations on prevention of cardiovascular diseases.	HRQoL ^\|\| (SF ^\|\|\|\| -36) Anxiety (State - Trait Anxiety Inventory) Improvement of cardiovascular risk factors	There were no significant differences between groups in HRQOL ^\|\| scores at baseline or end of the study. However, in the “physical health” domain of the SF ^\|\|\|\| -36, there was a 2.8-point increase in IG ^‡ (p = 0.011). IG ^‡ were more likely to experience an improvement in their cardiovascular risk factor profile (relative risk 1.4; 95% confidence interval 1.1-1.7) than patients in CG ^† (p = 0.010).
Koehler, et al. ( ⁶⁴ ) 2011 Germany	Individuals diagnosed with HF* n:710 (CG ^†: 356\|IG ^‡: 354) Follow-up: 12 months	Remote self-management system based on telemedicine	Remote telemonitoring system, consisting of: Personal digital assistant ECG ^†††† Scale BP ^¶¶¶ monitor Telemedicine center, with 24-hour medical support	Usual care was not detailed, cited as standard recommendations of guidelines for the treatment of HF*	Mortality Hospitalizations Depression (PHQ-9 ^§§§§ ) HRQoL ^\|\| (SF ^\|\|\|\| -36)	The study results showed that the intervention had no significant impact on all-cause mortality or cardiovascular mortality or hospitalization for HF* compared with CG ^† . Furthermore, there was a significant improvement in the SF ^\|\|\|\| -36 physical functioning score in IG ^‡ throughout the study period (p<0.05).
Baker, et al. ( ⁶⁵ ) 2011 The United States of America	Individuals diagnosed with HF* n: 605 (CG ^†: 303 \| IG ^‡: 302) Follow-up: 1 month	Telecoaching for self-management, initiated by 40-minutes educational sessions on HF* management	Follow-up phone calls and health guidance and education	40-minute educational session on the management of HF*, other usual care was not detailed	HRQL ^\|\| (HFSS ^¶¶¶¶ ) Knowledge (Improving Chronic Illness Care Evaluation)	There were no significant changes in HRQOL ^\|\| of the CG ^† from baseline to the end of follow-up, but in the IG ^‡ there was a difference from 58.6 (±22.2) at baseline to 65.3 (±22.4) at the end of 30 days (p = 0.001). The IG ^‡ showed a greater increase in general knowledge (0.70 vs. 0.30, p = 0.008) and in self-efficacy (0.4 vs. 1.0, p = 0.006)
Copeland, et al. ( ⁶⁶ ) 2010 The United States of America	Individuals diagnosed with HF* n:458 (CG ^†: 238\|IG ^‡: 220) Follow-up: 12 months	Disease management program, with scheduled phone calls by nurses, providing education, coaching for behavior change and symptoms monitoring	Scheduled phone calls from nurses Individualized self-management plan 24-hour nurse advice line Fax alerts to physicians about signs of decompensation	Usual care was not described	HRQoL ^\|\| (SF ^\|\|\|\| -8) Health costs Survival Adherence and satisfaction with care	After one year, there were no significant clinical differences between groups. HF*-related costs and overall costs were higher in IG ^‡ . This group also reported better adherence to weight monitoring and exercise recommendations. There were no differences in HRQoL ^\|\| , use of hospitalization, or survival between groups.
Balk, et al. ( ⁶⁷ ) 2008 Netherlands	Individuals diagnosed with HF* n: 214 (CG ^†: 113\| IG ^‡: 101) Follow-up: 9.6 months	Motiva ^® Health Education and Self-Management System	TV channel with educational material Medication reminders Health-related questionnaires Motivational SMS ^§§ Telemonitoring of BP ^¶¶ and weight Telephone contact by nurses	Standard follow-up provided by cardiologists and HF* nurses as per local practice	Days of hospitalization/year HRQoL ^\|\| (SF ^\|\|\|\| -36; MLHFQ ^\|\|\|\|\|\| ) Knowledge of the disease Self-care (European Heart Failure Self-care Behaviour Scale)	There were no significant differences for the primary outcomes, HRQoL ^\|\| or self-care behavior. However, there was a greater increase in knowledge about HF* in the IG ^‡ compared to the CG ^† (p<0.001)
Schwarz, et al. ( ⁶⁸ ) 2008 The United States of America	Individuals diagnosed with HF* or caregivers n:102 (CG ^†: 51\| IG ^‡: 51) Follow-up: 3 months	Remote monitoring system, associated with regular monitoring by healthcare professionals.	Telemonitoring system linked to the patient’s telephone line: Daily weight measurement Questionnaire on symptoms, medication adherence and sodium intake Telephone contact with caregiver, if necessary	Usual care was not detailed, being mentioned only as post-discharge care.	New hospitalizations Emergency visits Costs HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| )	The pilot study found no statistically significant differences in IG ^‡ regarding hospital readmissions, emergency department visits, costs, or risk of hospital readmission. HRQOL ^\|\| improved significantly in both groups at the 90-day follow-up visit (p<0.0001)
Wakefield, et al. ( ⁶⁹ ) 2008 The United States of America	Individuals diagnosed with HF* n:148 (CG ^†: 49\|IG ^‡ Video:52\| IG ^‡ Phone:47) Follow-up: 12 months	Telehealth program, based on telephone or video follow-up, symptom monitoring and health education	Symptom review checklist Daily monitoring of weight, BP ^¶¶ and ankle circumference Telephone contact Video call contact Behavioral skills training Strategies to maximize self-monitoring and self-efficacy Review and reinforcement of discharge plans	Standard hospital discharge guidance from the health service and telephone contact with the case manager nurse, if necessary	Number of readmissions Time to first readmission Emergency unit visits Survival HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| )	There was no difference in days of hospitalization or emergency department visits among the 3 groups. For all groups, HRQoL ^\|\| scores improved over time (F = 8.90, p = 0.0002). The magnitude of change was greatest in IG ^‡ Phone, followed by IG ^‡ Video and CG ^†
Woodend, et al. ( ⁷⁰ ) 2008 Canada	Individuals diagnosed with HF* or angina n:249 (CG ^†: 125\|IG ^‡: 124) Follow-up: 12 months Send feedback	Home telemonitoring program consisting of video consultations, monitoring of vital parameters, telephone support and structured educational content	Home monitoring equipment: Scales BP ^¶¶ monitor 12-lead ECG ^†††† Video consultations with a nurse Electronic data logging 24-hour nursing advice line	Usual treatment care provided to patients with angina or HF* who are discharged from hospital, without further details	Functional status (MLHFQ ^\|\|\|\|\|\| ; Seattle Angina Questionnaire) HRQoL ^\|\| (SF ^\|\|\|\| -36) Use of health resources (hospitalizations, days of hospitalization, emergency room visits)	HRQOL ^\|\| was better in HF* patients in the IG ^‡ compared to the CG ^† in five of the eight SF ^\|\|\|\| -36 subscales at 3 months (p < 0.05). The most significant differences in HRQoL ^\|\| between the two groups were detected at this time point. Patients in both groups demonstrated significant improvements in HRQOL ^\|\| over time in all SF ^\|\|\|\| -36 subscales.
López Cabezas, et al.( ⁷¹ ) 2006 Spain	Individuals diagnosed with HF* n: 134 (CG ^†: 64 \| IG ^‡: 70) Follow-up: 12 months	Pharmacist-led health guidance program with telephone support for questions or problems	Written and audiovisual educational material on the symptoms and pathogenesis of HF*; Telephone calls by the pharmacist	Regular consultations with a cardiologist and pharmacist	Readmissions Treatment adherence HRQoL ^\|\| (EQ-5D ^‡‡ ) Patient satisfaction	In IG ^‡ , there was greater adherence to treatment (85.0 vs. 73.9%), fewer days of hospitalization (CG ^† 9.6 vs. IG ^‡ 5.9) and greater satisfaction (p = 0.026) when compared to CG ^† . There was a significant reduction in hospital readmissions in IG ^‡ (54% at the beginning vs. 32% at the end), but there were no significant differences in HRQoL ^\|\| .
Riegel et al. ( ⁷² ) 2006 The United States of America	Individuals diagnosed with HF* n: 134 (CG ^†: 65 \| IG ^‡: 69) Follow-up: 6 months	Telephone case management, focusing on education, monitoring and guidance, as well as reporting and contact with medical staff	Decision support software (At Home with Heart Failure) Monthly mailing of printed educational material to patients Telephone support	Non-standardized usual care based on education on HF management*	Hospitalizations, hospital days and acute care costs (by HF* and all causes) Multiple readmissions All-cause mortality HRQoL ^\|\| (EQ-5D ^‡‡ )	No significant differences were found between groups in readmission rate, hospitalization days, cost of care, mortality, HRQoL ^\|\| or depression
Benatar, et al. ( ⁷³ ) 2003 The United States of America	Individuals diagnosed with HF* n:216 (CG ^†: 108\| IG ^‡: 108) Follow-up: 3 months	Home telemonitoring system, based on self-management devices with telephone assessments, with definition of individual clinical goals	Home monitoring devices to measure weight, BP ^¶¶ , HR** and oxygen saturation level Remote management team with contact via telephone calls	Usual care consisted of health monitoring via the center and home nursing visits	HRQoL ^\|\| (MLHFQ ^\|\|\|\|\|\| \| 70-item Quality of Life Index – Cardiac) Anxiety and depression (HADS*****) Self-efficacy (Heart Failure Self-Efficacy scale 30) Hospitalizations Health costs	The IG ^‡ group had fewer HF* readmissions (13 vs. 24; P≤0.001), with a shorter hospital length of stay (49.5 vs. 105.0 days; P≤0.001) and lower hospital costs at 3 months ($65,023 vs. $177,365; p≤0.02). Both groups experienced an improvement in HRQoL ^\|\| after the intervention
Barnason, et al. ( ⁷⁴ ) 2003 The United States of America	Individuals with ischemic HF* undergoing myocardial revascularization n:35 (CG ^†: 17\| IG ^‡: 18) Follow-up: 3 months	Health Buddy: Symptom assessment and education on post-revascularization recovery, symptom management, functioning, and adherence to CAD ^‡‡‡ risk factor modification	Telecommunication device connected to the patient’s phone (Health Buddy) Website where the collected data is stored	Education and counseling on post-surgical recovery care, self-care and modification of CAD ^‡‡‡ risk factors, prescription of home exercises, provided to all patients undergoing revascularization prior to hospital discharge	Self-efficacy (Barnason Efficacy Expectancy Scale) HRQoL ^\|\| (MOS SF-36 ^{†††††} )	The IG ^‡ had significantly higher adjusted mean self-efficacy scores (p < 0.05), adjusted mean levels of physical, general, mental and vitality functioning (p < 0.05), significantly higher exercise adherence (p < 0.01) and lower reported stress (p < 0.01) at three months post-surgery compared to the CG ^† . There was a significant improvement in pain and emotional functioning scores over time (p < 0.05)

Certainty Assessment							Number of Patients		Effect		Garin, et al	Importance
Number of Studies	Study Design	Risk of Bias	Inconsistency	Indirect Evidence	Imprecision	Other Considerations	Telemedicine	Usual Care	*Relative (95% CI)**	*Absolut (95% CI)**	Garin, et al	Importance
Health-related quality of life (follow-up: average 8.9 months; assessed with: EuroQol (EQ-5D ^† \| EQ-5D-5L ^‡ \| EQ-5D-Y ^§ ); Scale for: 0 to 100)
7	Randomized clinical trials	Very critical ^\|\|	Not critical	Not critical	Not critical	None	649	613	-	0 (0 to 0)	⨁⨁◯◯ Low	CRITICAL
Health-related quality of life (follow-up: average 7.8 months; assessed with: MLHFQ ^¶ \| HFSS**; Scale from: 0 to 105)
13	Randomized clinical trials	Very critical ^††	Not critical	Not critical	critical ^‡‡	None	1309	1102	-	0 (0 to 0)	⨁ ◯◯◯ Very Low	CRITICAL
Health-related quality of life (follow-up: mean 8.8 months; assessed with: SF ^§§ -36 \| SF ^§§ -12 \| SF ^§§ -8; Scale from: 0 to 100)
16	Randomized clinical trials	Very critical ^\|\|\|\|	Not critical	Not critical	Not critical	None	2850	2800	-	0 (0 to 0)	⨁ ⨁ ◯◯ Low	CRITICAL
Health-related quality of life (follow-up: average 10.5 months; assessed with: KCCQ ^¶¶ ; Scale of: 0 to 100)
4	Randomized clinical trials	Very critical***	Not critical	Not critical	Not critical	None	1497	1528	-	0 (0 to 0)	⨁ ⨁ ◯◯ Low	CRITICAL
Health-related quality of life (follow-up: average 9 months; assessed with: HeartQol ^††† ; Scale of: 0 to 3)
2	Randomized clinical trials	Very critical ^‡‡‡	Not critical	Not critical	Not critical	None	127	126	-	0 (0 to 0)	⨁ ⨁ ◯◯ Low	CRITICAL
Health-related quality of life (follow-up: average 3 months; assessed with: MacNew; Scale from: 1 to 7)
2	Randomized clinical trials	Very critical ^‡‡‡	Not critical	Not critical	Not critical	None	67	64	-	0 (0 to 0)	⨁ ⨁ ◯◯ Low	CRITICAL

Study	Follow-up (months)	Instrument	Group	n	*Initial Score Mean (SD)**	*Final Score Average (SD)**	p-value	*Change Mean (SD)**	Difference between groups (p-value)
Choi, et al. ( ³¹ )	3	MacNew	CG ^†	38	5.45 (0.86)	5.34 (1.09)	-	-	0.771
			IG ^‡	38	5.62 (0.82)	5.62 (0.78)	-	-
Dalli Peydró, et al. ( ³² )	10	EQ-5D-5L ^§	CG ^†	28	70 (65-85)	80 (70-90)	0.008	-	>0.800
			IG ^‡	31	75 (60-90)	88 (68-90)	0.064	-
Chow, et al. ( ³³ )	12	SF ^\|\| -12	CG ^†	708	-	PS ^¶: 47.6(-)MCS**: 51.2 (-)	-	-	PS ^¶: 0.045
			IG ^‡	716	-	PS ^¶: 47.6 (9.5) MCS**: 48.9 (9.6)	-	-
Voller, et al. ( ³⁴ )	12	KCCQ ^††	CG ^†	319	59.3 (24.0)	-	-	-	<0.01
			IG ^‡	302	59.6 (23.0)	-	-	-
Brouwers, et al. ( ³⁵ )	12	EQ-5D-5L ^§	CG ^†	147	0.815 (0.010)	0.848 (0.016)	-	-	0.002
			IG ^‡	153	0.814 (0.011)	0.851 (0.015)	-	-
Maddison, et al. ( ³⁶ )	13	EQ-5D ^‡‡	CG ^†	153	64 (22)	-	-	-	-
			IG ^‡	153	62 (22)	-	-	-	-
Collins, et al. ( ³⁷ )	3	KCCQ ^††	CG ^†	245	-	-	-	-	0.25
			IG ^‡	246	-	-	-	-
Clays, et al. ( ³⁸ )	6	MLHFQ ^§§	CG ^†	22	30.0 (13.5)	-	0.58	1.7 (13.8)	0.5
			IG ^‡	34	32.1 (22.9)	-	0.7	-1.0 (14.4)
Batalik, et al. ( ³⁹ )	3	SF ^\|\| -36	CG ^†	28	50.9 (8.8)	61.5 (7.1)	0.01	-	0.56
			IG ^‡	28	53.1 (6.7)	62 (7)	0.01	-
Lunde, et al. ( ⁴⁰ )	12	HeartQoL ^\|\|\|\|	CG ^†	147	2.48 (0.54)	2.57 (0.51)	-	-	<0.05
			IG ^‡	153	2.43 (0.59)	2.64 (0.51)	-	-
		EQ-5D ^‡‡	CG ^†	147	72 (14)	75 (12)	-	-	<0.001
			IG ^‡	153	69 (18)	78 (16)	-	-
Piotrowicz, et al. ( ⁴¹ )	14-26	SF ^\|\| -36	CG ^†	425	88.8 (14.1)	88.9 (14.4)	-	-	0.008
			IG ^‡	425	89.7 (12.6)	91.2 (12.8)	-	-
Ávila, et al. ( ⁴² )	3	SF ^\|\| -36	CG ^†1	30	73.3 (15.1)	76.4 (16.4)	-	-	0.06
			CG ^†2	30	79.8 (16.1)	82.6 (15.8)	-	-
			IG ^‡	30	82.2 (13.3)	82.6 (13)	-	-
Cáceres, et al. ( ⁴³ )	6	SF ^\|\| -36	CG ^†	123	PS ^¶: 47.6 (9.5) MCS**: 48.9 (9.6)	PS ^¶: 50.1 (8.5) MCS**: 52.7 (7.5)	-	-	PS ^¶: 0.37 MCS**: 0.74
			IG ^‡	115	PS ^¶: 49.6 (8.6) MCS**: 50.8 (8.5)	PS ^¶: 52.5 (9.1) MCS**: 53.1 (8.6)	-	-
		AFEQT ^¶¶	CG ^†	123	64.8 (25.2)	80.2 (20.9)	-	-	0.09
			IG ^‡	115	66.3 (21)	79 (20.3)	-	-
		EQ-5D ^‡‡	CG ^†	123	0.85 (0.21)	0.91 (0.13)	-	-	0.98
			IG ^‡	115	0.88 (0.16)	0.94 (0.14)	-	-
Cichosz, et al. ( ⁴⁴ )	12	SF ^\|\| -36	CG ^†	154	PS ^¶: 40.3 (9.2) MCS**: 48.9 (11.4)	PS ^¶: 40.67 (10.2) MCS**: 46.65 (12.1)	-	-	NS***
			IG ^‡	145	PS ^¶: 40.3 (9) MCS** 47.4 (10)	PS ^¶: 40.58 (9.7) MCS**: 50.01 (11.5)	-	-	< 0.05
		KCCQ ^††	CG ^†	154	62.5 (20.4)	63.56 (21.2)	-	-	<0.01
			IG ^‡	145	64.7 (18.8)	66.31 (20.7)	-	-
Mizukawa, et al. ( ⁴⁵ )	24	MLHFQ ^§§	CG ^†	19	32.2 (27.8)	-	-	-	0.564
			IG ^‡1	20	37.3 (22.7)	-	-	-
			IG ^‡2	20	47.5 (26.8)	-	-	-
Pekmezaris, et al. ( ⁴⁶ )	3	MLHFQ ^§§	CG ^†	58	59.9	27.8	-	-	0.5
			IG ^‡	46	62.7	36.3	-	-
Peng, et al. ( ⁴⁷ )	4	MLHFQ ^§§	CG ^†	49	48.77 (12.21)	49.63 (12.39)	-	-	0.072
			IG ^‡	49	49.43 (12.25)	42.32 (8.83)	-	-
Wagenaar, et al. ( ⁴⁸ )	12	MLHFQ ^§§	CG ^†	150	23.0 (32.5)	26.5	-	-	0.003
			IG ^‡1	150	24.0 (31.0)	28.3	-	-
			IG ^‡2	150	23.0 (27.8)	25.5	-	-
Guo, et al. ( ⁴⁹ )	3	EQ-5D-Y ^†††	CG ^†	96	71.3	69.9	-	-	<0.05
			IG ^‡	113	86.5	87.2	-	-
Hwang, et al. ( ⁵⁰ )	6	MLHFQ ^§§	CG ^†	29	47 (19)	33 (21)	-	-	-
			IG ^‡	24	41 (22)	34 (23)	-	-
Jayaram, et al. ( ⁵¹ )	6	KCCQ ^††	CG ^†	765	58.6 (24.9)	68.5 (26.4)	0.11	-	0.01
			IG ^‡	756	60.7 (24.1)	72.3 (24.4)	0.01	-
Piotrowicz, et al. ( ⁵² )	2	SF ^\|\| -36	CG ^†	34	73.6 (25.6)	67.4 (25.9)	NS**	-	0.0001
			IG ^‡	77	79.0 (31.3)	70.8 (30.3)	0.001	-
Bekelman, et al. ( ⁵³ )	12	KCCQ ^††	CG ^†	193	36.9 (14.6)	54.2	-	-	0.97
			IG ^‡	199	37.9 (13.3)	53.6	-	-
Frederix, et al. ( ⁵⁴ )	6	HeartQoL ^\|\|\|\|	CG ^†	70	2.31 (0.59)	2.32 (0.58)	0.21	-	0.01
			IG ^‡	70	2.27 (0.63)	2.53 (0.44)	0.01	-
Maddison, et al. ( ⁵⁵ )	6	SF ^\|\| -36	CG ^†	86	PS ^¶: 51.9 (5.8) MCS**: 51.53 (8.4)	PS ^¶: 51.9(-) MCS**: 54(-)	-	-	PS ^¶: 0.2 MCS**: 0.61
			IG ^‡	85	PS ^¶: 51.6 (5.9) MCS**: 52.87 (6.94)	PS ^¶: 52.9(-) MCS**: 54.6(-)	-	-
		EQ-5D ^‡‡	CG ^†	86	0.8 (0.1)	0.83(-)	-	-	0.23
			IG ^‡	85	0.8 (0.1)	0.86(-)	-	-
Piotrowicz, et al. ( ⁵⁶ )	2	SF ^\|\| -36	CG ^†	75	81.6 (27.3)	62.2 (26.4)	-	-	NS***
			IG ^‡	77	79.3 (25.6)	70.5 (25.4)	-	-
Kraal, et al. ( ⁵⁷ )	3	MacNew	CG ^†	26	5.2 (0.8)	5.8 (0.7)	-	-	0.498
			IG ^‡	29	5.7 (0.7)	6.1 (0.5)	-	-
Varnfield, et al. ( ⁵⁸ )	1.5	EQ-5D ^‡‡	CG ^†	60	0.83 (0.8–0.9)	0.82 (0.7-0.9)	0.7	-	0.01
			IG ^‡	60	0.84 (0.8–0.9)	0.92 (0.9–1.0)	<0.001	-
Blum, et al. ( ⁵⁹ )	12	MLHFQ ^§§	CG ^†	102	37 (27)	18 (21)	-	-	NS***
			IG ^‡	104	42 (23)	24 (24)	-	-
		SF ^\|\| -36	CG ^†	102	PS ^¶: 35 (11) MCS**: 49 (13)	PS ^¶: 38 (11) MCS**: 55 (9)	-	-	-
			IG ^‡	104	PS ^¶: 37 (90) MCS**: 49 (12)	PS ^¶: 38 (10) MCS**: 52 (11)	-	-
Cui, et al. ( ⁶⁰ )	12	SF ^\|\| -36	CG ^†	55	44.61 (23.3)	49.05 (19.59)	-	-	0.5341
			IG ^‡1	61	45.93 (19.47)	55.63 (27.51)	-	-
			IG ^‡2	58	44.73 (17.79)	40.17 (23.38)	-	-
Hawkes, et al. ( ⁶¹ )	6	SF ^\|\| -36	CG ^†	215	46.7 (9.6)	46.7 (11.1)	-	0.3	0.73
			IG ^‡	215	45.8 (10.1)	46.4 (11.5)	-	-
Seto, et al. ( ⁶² )	6	MLHFQ ^§§	CG ^†	50	47.8 (22.6)	47.3 (23.4)	0.9	-	0.05
			IG ^‡	50	50.3 (29.1)	41.4 (26.7)	0.02	-
Blasco, et al. ( ⁶³ )	12	SF ^\|\| -36	CG ^†	101	-	-	-	-	NS***
			IG ^‡	102	-	-	-	-
Koehler, et al. ( ⁶⁴ )	12	SF ^\|\| -36	CG ^†	356	-	51.7 (1.4)	-	0.3	<0.05
			IG ^‡	354	-	53.8 (1.4)	-	-
Baker, et al. ( ⁶⁵ )	1	HFSS ^‡‡‡	CG ^†	303	64.8 (22.4)	64.1 (22.8)	-	-0.6	<0.001
			IG ^‡	302	58.6 (22.2)	65.3 (22.4)	-	6.7
Copeland, et al. ( ⁶⁶ )	12	SF ^\|\| -8	CG ^†	238	-	-	-	-	NS***
			IG ^‡	220	-	-	-	-
Balk, et al. ( ⁶⁷ )	9.6	MLHFQ ^§§	CG ^†	113	-	-	-	-	NS***
			IG ^‡	101	-	-	-	-
Schwarz, et al. ( ⁶⁸ )	3	MLHFQ ^§§	CG ^†	51	35.8 (21.5)	27.3 (21.6)	-	-	NS***
			IG ^‡	51	39.5 (23.3)	27.4 (21.7)	-	-
Wakefield, et al. ( ⁶⁹ )	12	MLHFQ ^§§	CG ^†	49	60.6 (19.3)	56.6 (23.9)	-	-	0.0002
			IG ^‡1	52	58.4 (22.9)	41.5 (26.9)	-	-
			IG ^‡2	47	60.2 (24.8)	54.0 (26.0)	-	-
Woodend, et al. ( ⁷⁰ )	12	SF ^\|\| -36	CG ^†	125	-	-	-	-	-
			IG ^‡	124	-	-	-	-
López Cabezas, et al. ( ⁷¹ )	12	EQ-5D ^‡‡	CG ^†	64	65 (17.6)	60.6 (17.8)	-	-	NS***
			IG ^‡	70	62.3 (17.3)	64 (15.4)	-	-
Riegel, et al. ( ⁷² )	6	EQ-5D ^‡‡	CG ^†	65	57.1 (16.7)	73.7 (17.4)	-	-	-
			IG ^‡	69	60.4 (19.9)	73.4 (17.4)	-	-	-
		MLHFQ ^§§	CG ^†	65	56.1 (16.7)	12.9 (10.9)	-	-
			IG ^‡	69	52.7 (19.6)	12.1 (12.3)	-	-
Benatar, et al. ( ⁷³ )	3	MLHFQ ^§§	CG ^†	108	77.17 (8.52)	57.72 (16.24)	0.47	-	<0.01
			IG ^‡	108	77.92 (10.3)	51.64 (17.36)	0.98	-
Barnason, et al. ( ⁷⁴ )	3	SF ^\|\| -36	CG ^†	17	60.7	69.1	-	-	-
			IG ^‡	18	60.7	78.3	-	-

vertical_align_top show_chart

more_horiz close
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3387 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

[1] *HF = Heart failure; ^†CG = Control Group; ^‡IG = Intervention Group; ^§NYHA = New York Heart Association; ^||HRQoL = Health-related quality of life; ^¶SCA = Acute coronary syndrome; **HR = Heart Rage; ^††VO₂ = Oxygen volume; ^‡‡EQ-5D = EuroQol-5 dimension-5 levels; ^§§SMS = Text messages; ^||||SF - Short form health survey; ^¶¶BP = Blood pressure; ***WHO-5 = Well-Being Index from the World Health Organization-5 itens; ^†††KCCQ = Kansas City Cardiomyopathy Questionnaire; ^‡‡‡CAD = Coronary artery disease; ^§§§EQ-VAS = EuroQol Visual Analogue Scale; ^||||||MLHFQ = Minnesota Living With Heart Failure Questionnaire; ^¶¶¶TC6M = 6-Minute Walk Test; ****HeartQoL = Health-related quality of life questionnaire; ^††††ECG = Electrocardiogram; ^‡‡‡‡AF = Atrial fibrillation; ^§§§§PHQ-9 = Patient Health Questionnaire-9 items; ^||||||||AMI = Acute myocardial infarction; ^¶¶¶¶HFSS = Heart Failure Symptom Scale; *****HADS = Hospital Anxiety and Depression Scale; ^{†††††}MOS SF-36 = Medical Outcomes Short-Form Health Survey-36 items