Supplementary file 1_Comparative efficacy of digital health intervention delivery modalities on quality of life, anxiety, and depression in coronary heart disease: a systematic review and network meta-analysis.docx

Notably, telephone follow-up, with a SUCRA of 99.5%, appeared to be the most effective option. Regarding psychological outcomes, web-based platforms demonstrated the highest probability of being the best intervention for reducing both anxiety (SMD -1.56,95%CI-2.34 to -0.79;SUCRA 98.6%) and depression (SMD-1.07,95%CI-1.94to-0.20;SUCRA 91.4%).Safety analyses showed interactive modalities significantly reduced adverse events, whereas one-way SMS carried a significantly higher risk than interactive telephone support(OR 3.38,95%CI 1.13-10.13).</p>Conclusions<p>The research suggests that telephone follow-up ranked highest among the included studies for improving short-term QoL, while web-based platforms showed a high probability of being effective for alleviating long-term anxiety and depression.

However, these rankings should be interpreted cautiously, as intervention content, duration, and patient populations varied considerably across trials, and the small number of studies for certain modalities limits the robustness of direct comparisons. Social media interventions also emerged as a versatile option with benefits across all three outcomes, though their modest effect sizes warrant further optimization of engagement strategies.

Passive SMS interventions present potential safety concerns, as their unidirectional nature may attenuate timely symptom recognition and delay appropriate care-seeking—a hypothesis supported by their significantly higher adverse event rates compared with interactive modalities. These results provide crucial evidence-based support for healthcare providers to tailor specific DHIs to individual patient needs.</p>Systematic review registration<p>crd.york.ac.uk/PROSPERO/, identifier CRD420261380157.</p>