The effectiveness of nudge-based interventions on self-monitoring behaviours among patients with cardiometabolic diseases: a systematic review and meta-analysis

Cardiometabolic diseases are major global health concerns, leading to high morbidity and mortality. Self-monitoring is crucial for managing these conditions; however, the adherence to self-monitoring remains suboptimal. Nudge-based interventions, such as reminders and automatic prescription refills, have shown promise in improving self-monitoring behaviours. This systematic review and meta-analysis evaluated the effectiveness of nudge-based interventions on self-monitoring behaviours and health outcomes in this population. Thirty-five randomised controlled trials from seven databases (earliest available date to March 2025) were included. Nudge strategies were categorised according to the choice architecture taxonomy by Münscher et al. Meta-analysis demonstrated that nudge-based interventions were associated with significant improvements in self-monitoring behaviours in cardiometabolic patients (Hedge’s g = 0.56; 95% CI [0.44, 0.69]; p < 0.001) as well as reductions in HbA1c levels (MD = −0.50; p < 0.001), systolic blood pressure (MD = −4.47; p < 0.001), and diastolic blood pressure (MD = −2.02; p < 0.05) compared to the control group. Subgroup analyses indicated that the effect size of nudge interventions may vary by delivery mode, components, and intervention duration. Our findings suggest that integrating diverse behavioural nudges could optimise management strategies for these patients, enhancing both self-monitoring adherence and health outcomes.