Effectiveness of Nurse‐Led Telephone‐Based Follow‐Up Interventions on Health Outcomes in People With Acute Coronary Syndromes: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

BACKGROUND: Nurse-led telephone-based follow-up interventions play a role in patient follow-up, but at present, no meta-analysis has been found to assess the effectiveness of nurse-led, telephone follow-up interventions for patients with acute coronary syndrome. OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the effectiveness of nurse-led telephone-based follow-up interventions on health outcomes in people with acute coronary syndromes. DESIGN: Systematic review and meta-analysis of randomized controlled trials. METHODS: A comprehensive search of six databases: PubMed, Web of Science, Embase, Cochrane Library, CINAHL and Scopus was conducted from the inception of the databases to 30 September 2023. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the included randomized controlled studies. Review Manager 5.4 and Stata 16.0 were used to conduct statistical analysis. RESULTS: A total of 12 studies were included. Nurse-led telephone-based follow-up interventions may reduce systolic and diastolic blood pressure (MD = -2.55, 95% CI [-4.16, -0.94]) (MD = -2.15, 95% CI [-3.18, -1.12]) and low-density lipoprotein (MD = -9.06, 95% CI [-14.33, -3.79]) in patients with acute coronary syndrome. However, its effectiveness in controlling high-density lipoprotein (MD = 1.65, 95% CI [-4.30, 7.61]) and reducing total cholesterol (MD = -2.72, 95% CI [-7.57, 2.13]) was uncertain. In addition, the results showed that the nurse-led follow-up intervention did not play a role in improving anxiety (SMD = -0.20, 95% CI [-0.44, 0.04]) and depression (SMD = -0.07, 95% CI [-0.21, 0.06]) in patients with acute coronary syndrome, but it probably improved drug adherence (RR = 1.30, 95% CI [1.05, 1.60]) and smoking cessation (RR = 1.31, 95% CI [1.08, 1.60]). LINKING EVIDENCE TO ACTION: The findings of this review suggest that nurse-led telephone-based follow-up interventions had a potentially positive effect on controlling blood pressure and low-density lipoprotein levels, as well as improving medication adherence and smoking cessation among patients with acute coronary syndrome, compared to usual care. However, the intervention did not appear to significantly impact high-density lipoprotein, total cholesterol, anxiety, and depression, indicating that further research in these areas will be necessary in the future. TRIAL REGISTRATION: PROSPERO (International Prospective Register of Systematic Reviews): CRD42023465894.