背景：心血管疾病患者不坚持用药会损害预期的治疗结果。eHealth干预措施成为有效解决这一问题的有希望的策略。
目的：这项研究的目的是进行网络荟萃分析（NMA），以比较和排名各种电子健康干预措施在改善心血管疾病（CVDs）患者服药依从性方面的功效。
方法：在PubMed中进行了系统的搜索策略，Embase,WebofScience,科克伦,中国国家知识基础设施图书馆(CNKI),中国科技期刊数据库(维普),和万方数据库搜索从2024年1月15日开始发表的随机对照试验(RCT)。我们进行了频繁的NMA来比较各种电子健康干预措施的疗效。使用Cochrane手册（2.0版）中的偏见风险工具评估文献的质量，提取的数据使用Stata16.0(StataCorpLLC)和RevMan5.4软件(CochraneCollaboration)进行分析.使用建议分级评估证据的确定性，评估,发展,和评估(等级)方法。
结果：共纳入21项RCTs，涉及3904例患者。NMA显示，联合干预(标准化平均差[SMD]0.89，95%CI0.22-1.57)，电话支持（SMD0.68，95%CI0.02-1.33），远程监护干预措施(SMD0.70，95%CI0.02-1.39)，和手机应用干预（SMD0.65，95%CI0.01-1.30）在统计学上优于常规治疗。然而,SMS与平常照护比拟无统计学差别。值得注意的是,联合干预，累积排名曲线下的曲面为79.3%，似乎是最有效的心血管疾病患者的选择。关于收缩压和舒张压结果，联合干预措施成为最佳干预措施的可能性也最高.
结论：研究表明，联合干预（SMS短信和电话支持）最有可能成为改善心血管疾病患者服药依从性的最有效的电子健康干预措施。其次是远程监测，电话支持,和应用程序干预。这些网络荟萃分析的结果可以为医疗保健提供者提供关键的循证支持，以提高患者的用药依从性。鉴于电子健康干预措施的设计和实施存在差异，进一步大规模，需要精心设计的多中心试验。
背景：INPLASY2023120063;https://inplasy.com/inplasy-2023-12-0063/。
BACKGROUND: Nonadherence to medication among patients with cardiovascular diseases undermines the desired therapeutic outcomes. eHealth interventions emerge as promising strategies to effectively tackle this issue.
OBJECTIVE: The aim of this study was to conduct a network meta-analysis (NMA) to compare and rank the efficacy of various eHealth interventions in improving medication adherence among patients with cardiovascular diseases (CVDs).
METHODS: A systematic search strategy was conducted in PubMed, Embase, Web of Science, Cochrane,
China National Knowledge Infrastructure Library (CNKI),
China Science and Technology Journal Database (Weipu), and WanFang databases to search for randomized controlled trials (RCTs) published from their inception on January 15, 2024. We carried out a frequentist NMA to compare the efficacy of various eHealth interventions. The quality of the literature was assessed using the risk of bias tool from the Cochrane Handbook (version 2.0), and extracted data were analyzed using Stata16.0 (StataCorp LLC) and RevMan5.4 software (Cochrane Collaboration). The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach.
RESULTS: A total of 21 RCTs involving 3904 patients were enrolled. The NMA revealed that combined interventions (standardized mean difference [SMD] 0.89, 95% CI 0.22-1.57), telephone support (SMD 0.68, 95% CI 0.02-1.33), telemonitoring interventions (SMD 0.70, 95% CI 0.02-1.39), and mobile phone app interventions (SMD 0.65, 95% CI 0.01-1.30) were statistically superior to usual care. However, SMS compared to usual care showed no statistical difference. Notably, the combined intervention, with a surface under the cumulative ranking curve of 79.3%, appeared to be the most effective option for patients with CVDs. Regarding systolic blood pressure and diastolic blood pressure outcomes, the combined intervention also had the highest probability of being the best intervention.
CONCLUSIONS: The research indicates that the combined intervention (SMS text messaging and telephone support) has the greatest likelihood of being the most effective eHealth intervention to improve medication adherence in patients with CVDs, followed by telemonitoring, telephone support, and app interventions. The results of these network meta-analyses can provide crucial evidence-based support for health care providers to enhance patients\' medication adherence. Given the differences in the design and implementation of eHealth interventions, further large-scale, well-designed multicenter trials are needed.
BACKGROUND: INPLASY 2023120063; https://inplasy.com/inplasy-2023-12-0063/.
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