Effect of Nurse-Led mHealth Educational Intervention on Self-Care Behavior, Clinical Outcomes, and Quality of Life Among Heart Failure Patients: A Systematic Review of Randomized Controlled Trials.

Background: As a prevalent global health issue, heart failure presents a significant challenge. However, nurse-led mobile Health (mHealth) interventions have demonstrated efficacy in fostering self-care practices, resulting in improved patient outcomes. Objective: This systematic review aimed to explore prevailing trends and approaches in nurse-led mHealth interventions and assess their effectiveness in managing patients with heart failure. Methods: An extensive literature search was conducted across six databases (PubMed, Embase, Web of Science, MEDLINE, Cochrane Database of Systematic Reviews, and SCOPUS). The search covered studies from 2015 to April 2025. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a total of 24 studies were selected based on pre-defined eligibility criteria. Two independent reviewers screened the studies and extracted the relevant data. The quality of the included studies was evaluated, and analysis was performed using RevMan 5.3. Results: The mHealth interventions improved self-care and psychosocial well-being. Specifically, these interventions enhanced quality of life, reduced depression and anxiety, and increased patient satisfaction. They also led to improved cardiac function (6-minute walk test) and reduced rehospitalization rates and healthcare costs. Conclusions: Nurse-led mHealth interventions significantly improve heart failure management by strengthening self-care practices, medication adherence, quality of life, and cardiac function, while reducing depression, anxiety, rehospitalizations, and costs. Further large-scale studies are needed to confirm their overall effectiveness. Prospero Registration no: CRD420251062783. keywords: Heart failure, mHealth, self-care behavior, clinical outcomes, quality of life, systematic review.