Heart failure is a global health crisis, affecting millions worldwide and straining healthcare systems. This study explores the potential of telehealth interventions to revolutionize heart failure management, focusing on self-care, hospitalization rates, and quality of life. The research aims to identify best practices by analyzing various telehealth models and content, filling a gap in existing reviews. The systematic review includes 28 randomized controlled trials, following PRISMA guidelines and registered in PROSPERO. Eligibility criteria were based on the PICOT framework, targeting heart failure patients and telehealth interventions. The study selection process yielded 28 studies, with most demonstrating good methodology. However, some methodological issues were identified, such as unclear blinding procedures and limited long-term follow-up. The analysis revealed three main telehealth models: telemonitoring, phone call support, and mobile/web-based applications. Telemonitoring, using technology for real-time patient monitoring, showed high effectiveness in reducing hospitalization rates and improving quality of life. Phone call support provided educational and emotional support, but its outcomes were controversial. Mobile/web-based applications enabled independent patient monitoring, medication reminders, and education, with varying results. The thematic analysis highlighted similarities in core content across models, emphasizing monitoring, health literacy, self-care skills, and emotional and clinical support. Telemonitoring had broader and more detailed content coverage, including comprehensive clinical parameters. Phone call support offered a simple, flexible, and low-cost approach, suitable for moderate-risk patients. Mobile/web-based applications provided personalized interventions, but effectiveness depended on digital literacy and consistency of use. The study's strengths include a rigorous methodology and diverse study populations, but limitations include heterogeneity in interventions and patient characteristics, methodological weaknesses, and lack of long-term follow-up. In conclusion, telehealth interventions show substantial potential in optimizing heart failure management, but outcome variability remains. The review underscores the need for standardized intervention content, sustained engagement strategies, and integration into existing health systems. Future research should prioritize long-term effectiveness, address digital literacy barriers, and explore scalable, cost-effective models to ensure equitable access and sustainable implementation.
