Digital education for cardiac care readiness among coronary heart disease patients in low- and middle-income countries: a scoping review.

Introduction

Coronary heart disease (CHD) is the leading cause of cardiovascular mortality worldwide, with the greatest burden concentrated in low- and middle-income countries (LMICs). Patient readiness-encompassing knowledge, self-efficacy, and self-care behaviour-is a critical determinant of post-discharge outcomes. Digital education interventions offer an innovative, resource-efficient approach to improving CHD patient readiness in LMICs; however, the available evidence has not been systematically mapped.

Methods

This scoping review followed the Arksey and O'Malley framework and was reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). A systematic search was conducted across four databases-PubMed, ScienceDirect, Wiley Online Library, and the Cochrane Library-for publications from 2019 to 2026. The most recent searches were run on 1 March 2026 and supplemented by manual screening of reference lists.

Results

Eleven studies were included, comprising 7 full RCTs (63.6%), 1 pilot RCT (9.1%), 2 RCT protocols (18.2%), and 1 feasibility study (9.1%). Geographic distribution included China (n = 4; 36.4%), Iran (n = 4; 36.4%), Colombia (n = 1; 9.1%), Tunisia (n = 1; 9.1%), and Brazil (n = 1; 9.1%). The most frequently used primary delivery platforms were mobile applications/smartphones (n = 3; 27.3%), WeChat (n = 2; 18.2%), WhatsApp (n = 2; 18.2%), Web-based/online platforms (n = 2; 18.2%), augmented reality (n = 1; 9.1%), and digital multimedia (n = 1; 9.1%). The most commonly measured outcomes were self-efficacy (n = 4; 36.4%), quality of life (n = 3; 27.3%), disease knowledge/illness perception (n = 3; 27.3%), medication adherence/self-management (n = 3; 27.3%), and clinical events (n = 1; 9.1%). Discharge readiness was not measured as a primary outcome in any included study.

Conclusion

Digital education interventions show promising potential for improving the components of CHD patient readiness in LMICs; however, the evidence remains concentrated in China and Iran. Research specifically targeting discharge readiness with validated instruments is urgently needed across diverse LMIC settings, particularly in Southeast Asia, sub-Saharan Africa, and Latin America.