Effectiveness of eHealth Interventions for Adolescents and Young Adults With Congenital Heart Disease: Systematic Review.

Résumé

BACKGROUND: Adolescents and young adults (AYAs) with complex congenital heart disease (CHD) may benefit from eHealth interventions, particularly when early signs of deterioration or self-management challenges arise. eHealth can enhance self-management skills and communication with health care professionals (HCPs). However, systematic reviews examining eHealth interventions for this population remain limited and heterogeneous, indicating a need for a systematic review of the literature to guide the development, implementation, and evaluation of such interventions.OBJECTIVE: In this systematic review, we aimed to synthesize the content, theoretical foundations, outcomes, and effectiveness of eHealth interventions targeting AYAs with complex CHD that involve interaction with HCPs.METHODS: We conducted this systematic review in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. An a priori protocol was registered in PROSPERO (CRD42023400211). The review was reported according to the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), the PRISMA-S (PRISMA Literature Search Extension), and the SWiM (Synthesis Without Meta-Analysis) checklists. The final comprehensive bibliographic search was conducted on March 16, 2026, across MEDLINE ALL (Ovid), Embase (Ovid), APA PsycInfo (Ovid), ERIC (EBSCOhost), CINAHL (EBSCOhost), and the Web of Science Core Collection (Clarivate). Studies were eligible if they included AYAs aged 10-29 years diagnosed with CHD who received eHealth interventions delivered by HCPs regardless of care setting; measured effects of eHealth interventions using experimental or quasiexperimental designs; and were published in English or a Scandinavian language. The researchers assessed eligibility in pairs, risk of bias using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) for randomized studies and the Risk of Bias in Non-Randomized Studies of Exposures (ROBINS-E) for nonrandomized studies, and extracted data. Overall risk of bias was high. Due to heterogeneity among the included studies, a narrative synthesis was conducted.RESULTS: We included 8 studies, with sample sizes ranging from 20 to 158, totaling 551 participants. Five studies reported improvements in the eHealth intervention groups, evaluating educational interventions to improve disease-specific knowledge, self-management, physical activity, psychosocial impact, and transition readiness in AYAs with CHD. However, the content, delivery mode and format, and target outcomes varied across studies. Seven studies lacked a theoretical foundation for the intervention.CONCLUSIONS: The evidence remains inconsistent and limited by heterogeneity, absence of theoretical foundations, risk of bias, and high dropout rates; further refinement is thus needed. Future research may benefit from theory-driven, user-centered, co-designed approaches with AYAs with CHD from the outset to enhance relevance, engagement, and long-term sustainability. Standardized outcome measures and long-term evaluations could clarify the long-term impact and implementation potential of eHealth interventions. This study emphasizes factors like tailoring content to medical complexity, integrating interactive interprofessional teams, and incorporating structured peer support in planning and developing eHealth intervention research in the future.