Efficacy of digital psychological interventions for psychological outcomes in cardiovascular patients: a systematic review and network meta-analysis

AIMS: This study aims to determine the efficacy of digital psychological interventions for specific psychological outcomes, including depression, anxiety, stress, insomnia, fatigue, and quality of life in patients with cardiovascular disease. METHODS AND RESULTS: Randomized controlled trials evaluating digital psychological interventions for adult cardiovascular diseases patients were systematically searched in PubMed, Embase, CINAHL, Cochrane Library, Web of Science, CNKI, Wan Fang, and VIP up to July 2025. Primary outcomes were depression and anxiety, while secondary outcomes included stress, insomnia, fatigue, and quality of life. The consistency model was used to conduct a network meta-analysis. Thirty-six randomized controlled trials involving 5486 participants were included. Digital psychological interventions significantly improved psychological outcomes compared with controls. Telemedical interventional monitoring was most effective for reducing depression (SUCRA = 84.1%), while cognitive behavioural therapy ranked highest for anxiety (SUCRA = 84.7%) and stress (SUCRA = 98.7%). Health education showed the greatest benefit for quality of life (SUCRA = 99.6%). Evidence for insomnia and fatigue was limited but suggested potential benefits of digital interventions. CONCLUSION: Based on the analysis in this study, telemedicine intervention monitoring shows the most promise to alleviate depressive symptoms, cognitive behavioural therapy shows potential in reducing anxiety and stress, and health education was associated with the most significant improvements in quality of life. Our findings suggest that integrating personalized digital interventions into cardiac rehabilitation programmes may be promising, while also highlighting the need for further research into long-term efficacy and multimodal intervention approaches. REGISTRATION: PROSPERO: CRD420251110636.