Comparative Systematic Review of Telehealth Delivery Models, Intervention Content, and Outcomes in Heart Failure Care.

Background: Heart failure management remains challenging due to limited self-care and prevalent depressive symptoms, with telehealth emerging as an effective approach to strengthen disease management and enhance patients' quality of life. However, studies that specifically explore models, intervention content, and the broader benefits of telehealth in HF management are still limited. Purpose: This systematic review aimed to compare and synthesize different telehealth delivery models, intervention content, and associated outcomes in the management of patients with heart failure. Methods: A systematic review was conducted in accordance with Cochrane and PRISMA guidelines. A comprehensive search was conducted across multiple databases, including PubMed, Scopus, EBSCOhost, Taylor & Francis, and Springer Nature, with a focus on randomised controlled trials (RCTs) published in English. The article selection process is based on title, abstract, full text, and eligibility criteria, including quality appraisal. Data analysis employed thematic synthesis and descriptive qualitative approaches to categorize interventions, content, and outcomes. Results: The review included 28 studies, evaluating three main telehealth intervention models: (1) telemonitoring, (2) phone call support, and (3) smartphone and web-based applications. Intervention content included symptom and medication monitoring, patient education, empowerment for self-management, reminders and feedback, psychological and social support, and healthcare communication. The study outcomes were categorized into four themes, including clinical outcomes, physical and mental health outcomes, behavioral outcomes, and quality of life. Among these models, phone call support and reminder interventions were most often recommended as practical and feasible approaches, as they are easy to implement, and flexible. Conclusion: This review highlights that while telehealth interventions consistently improve quality of life, their impact on mental health and long-term clinical outcomes remains variable. Integrating support models with phone calls and reminders into routine heart failure management may improve accessibility and continuity of care, particularly for patients requiring ongoing behavioral and emotional support.