# Engaging Patients with Heart Failure in Diet and Nutritional Health Behaviors Through mHealth Applications – A Restricted, Systematic Review

## TL;DR

This paper reviews mobile apps for heart failure patients to see how well they support diet and nutrition behaviors.

## Contribution

It identifies gaps in mHealth apps for heart failure and suggests improvements in design and integration of nutrition guidance.

## Key findings

- Nine recent studies were reviewed, but no app was solely focused on diet or nutrition for heart failure.
- Engagement features like personalized feedback and reminders improved adherence to health behaviors.
- User-centered design and co-creation with patients are needed to improve app usability and effectiveness.

## Abstract

To examine recent mHealth interventions aimed at supporting diet and nutrition behaviours in heart failure (HF). The review included studies of mobile applications (apps) that incorporated at least one diet- or nutrition-related component published in the last 5 years, in English and targeted for a heart failure population. The review summarises diet and nutrition features and evaluation, engagement strategies within these apps, and reporting of how strategies relate to changes in nutrition-focused health behaviours in people with HF. The review was restricted by period (years) of articles retrieved, percentage of duplication in researchers checking the inclusion and data extraction, and number of databases searched.

A total of nine studies (2019–2023) met the inclusion criteria. No mHealth application was solely dedicated to diet or nutritional health behaviours in heart failure (HF). Engagement features included personalised feedback, goal setting, reminders, and gamification, which appeared to improve adherence. Ease of use and technical support facilitated patient technology uptake, whereas burdensome data entry and complex interfaces hindered it.

MHealth apps exist for supporting HF self-care, but only a few include diet and nutrition support. Future app development should integrate robust diet and nutrition guidance alongside standard HF-care. Emphasis on user-centred design, including co-creation with patients and intuitive interfaces is essential to improve usability and engagement. Research is needed to incorporate diet and nutrition management integrate in mHealth tools for those with HF.

The online version contains supplementary material available at 10.1007/s11897-025-00739-4.