Table 4_Digital health education and self-management support for adults with heart failure: a best-evidence summary of review-level evidence.docx

Eligible evidence included systematic reviews, meta-analyses, network meta-analyses, umbrella reviews, systematic metareviews and scoping reviews indexed in the searched databases. Two reviewers independently screened sources, extracted data and appraised methodological quality using AMSTAR 2 or PRISMA-ScR/JBI-informed criteria. Evidence statements were developed using review quality, directness, consistency, feasibility and likely overlap among primary studies; no recommendation grade was assigned.

Of 8,698 records identified, 5,331 were screened after de-duplication, 37 full-text reports were assessed and 27 review-level evidence sources were included. Evidence varied substantially in quality, directness and intervention type. The final synthesis generated 27 practice-oriented statements organised into three tiers: essential core components, conditional implementation components, and emerging or outcome-related statements.

Review-level evidence suggests that digitally supported education and self-management may complement routine HF care, particularly when linked to structured clinical feedback, clearly assigned responsibility and escalation pathways. However, the evidence statements should be interpreted conditionally because of methodological limitations, indirectness, intervention heterogeneity and likely overlap among reviews.</p>