A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial
Abstract Digital health applications (apps) have the potential to improve health behaviors and outcomes. We aimed to examine the effectiveness of a consumer web-based app linked to primary care electronic health records (EHRs). CONNECT was a multicenter randomized controlled trial involving patients...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2020-09-01
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| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-020-00325-z |
| _version_ | 1827608588229541888 |
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| author | Julie Redfern Genevieve Coorey John Mulley Anish Scaria Lis Neubeck Nashid Hafiz Chris Pitt Kristie Weir Joanna Forbes Sharon Parker Fiona Bampi Alison Coenen Gemma Enright Annette Wong Theresa Nguyen Mark Harris Nick Zwar Clara K. Chow Anthony Rodgers Emma Heeley Katie Panaretto Annie Lau Noel Hayman Tim Usherwood David Peiris |
| author_facet | Julie Redfern Genevieve Coorey John Mulley Anish Scaria Lis Neubeck Nashid Hafiz Chris Pitt Kristie Weir Joanna Forbes Sharon Parker Fiona Bampi Alison Coenen Gemma Enright Annette Wong Theresa Nguyen Mark Harris Nick Zwar Clara K. Chow Anthony Rodgers Emma Heeley Katie Panaretto Annie Lau Noel Hayman Tim Usherwood David Peiris |
| author_sort | Julie Redfern |
| collection | DOAJ |
| description | Abstract Digital health applications (apps) have the potential to improve health behaviors and outcomes. We aimed to examine the effectiveness of a consumer web-based app linked to primary care electronic health records (EHRs). CONNECT was a multicenter randomized controlled trial involving patients with or at risk of cardiovascular disease (CVD) recruited from primary care (Clinical Trial registration ACTRN12613000715774). Intervention participants received an interactive app which was pre-populated and refreshed with EHR risk factor data, diagnoses and, medications. Interactive risk calculators, motivational messages and lifestyle goal tracking were also included. Control group received usual health care. Primary outcome was adherence to guideline-recommended medications (≥80% of days covered for blood pressure (BP) and statin medications). Secondary outcomes included attainment of risk factor targets and eHealth literacy. In total, 934 patients were recruited; mean age 67.6 (±8.1) years. At 12 months, the proportion with >80% days covered with recommended medicines was low overall and there was no difference between the groups (32.8% vs. 29.9%; relative risk [RR] 1.07 [95% CI, 0.88–1.20] p = 0.49). There was borderline improvement in the proportion meeting BP and LDL targets in intervention vs. control (17.1% vs. 12.1% RR 1.40 [95% CI, 0.97–2.03] p = 0.07). The intervention was associated with increased attainment of physical activity targets (87.0% intervention vs. 79.7% control, p = 0.02) and e-health literacy scores (72.6% intervention vs. 64.0% control, p = 0.02). In conclusion, a consumer app integrated with primary health care EHRs was not effective in increasing medication adherence. Borderline improvements in risk factors and modest behavior changes were observed. |
| first_indexed | 2024-03-09T07:15:11Z |
| format | Article |
| id | doaj.art-5610c9a019db40ccbb997a25d714f092 |
| institution | Directory Open Access Journal |
| issn | 2398-6352 |
| language | English |
| last_indexed | 2024-03-09T07:15:11Z |
| publishDate | 2020-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Digital Medicine |
| spelling | doaj.art-5610c9a019db40ccbb997a25d714f0922023-12-03T08:35:49ZengNature Portfolionpj Digital Medicine2398-63522020-09-01311910.1038/s41746-020-00325-zA digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trialJulie Redfern0Genevieve Coorey1John Mulley2Anish Scaria3Lis Neubeck4Nashid Hafiz5Chris Pitt6Kristie Weir7Joanna Forbes8Sharon Parker9Fiona Bampi10Alison Coenen11Gemma Enright12Annette Wong13Theresa Nguyen14Mark Harris15Nick Zwar16Clara K. Chow17Anthony Rodgers18Emma Heeley19Katie Panaretto20Annie Lau21Noel Hayman22Tim Usherwood23David Peiris24Faculty of Medicine and Health, The University of Sydney, Westmead Applied Research CentreThe George Institute for Global Health, UNSWThe George Institute for Global Health, UNSWThe George Institute for Global Health, UNSWSchool of Health and Social Care, Edinburgh Napier UniversityFaculty of Medicine and Health, The University of Sydney, Westmead Applied Research CentreThe George Institute for Global Health, UNSWThe George Institute for Global Health, UNSWThe George Institute for Global Health, UNSWSchool of Health and Social Care, Edinburgh Napier UniversityFiona Bampi - Cancer Australia, Australian GovernmentThe George Institute for Global Health, UNSWFaculty of Medicine and Health, The University of Sydney, Westmead Applied Research CentreCentre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of SydneyThe George Institute for Global Health, UNSWCentre for Primary Health Care and Equity, UNSWFaculty of Health Sciences & Medicine, Bond UniversityFaculty of Medicine and Health, The University of Sydney, Westmead Applied Research CentreThe George Institute for Global Health, UNSWThe George Institute for Global Health, UNSWCentre for Chronic Disease, The University of QueenslandAustralian Institute of Health Innovation, Macquarie UniversityQueensland HealthFaculty of Medicine and Health, The University of Sydney, Westmead Applied Research CentreThe George Institute for Global Health, UNSWAbstract Digital health applications (apps) have the potential to improve health behaviors and outcomes. We aimed to examine the effectiveness of a consumer web-based app linked to primary care electronic health records (EHRs). CONNECT was a multicenter randomized controlled trial involving patients with or at risk of cardiovascular disease (CVD) recruited from primary care (Clinical Trial registration ACTRN12613000715774). Intervention participants received an interactive app which was pre-populated and refreshed with EHR risk factor data, diagnoses and, medications. Interactive risk calculators, motivational messages and lifestyle goal tracking were also included. Control group received usual health care. Primary outcome was adherence to guideline-recommended medications (≥80% of days covered for blood pressure (BP) and statin medications). Secondary outcomes included attainment of risk factor targets and eHealth literacy. In total, 934 patients were recruited; mean age 67.6 (±8.1) years. At 12 months, the proportion with >80% days covered with recommended medicines was low overall and there was no difference between the groups (32.8% vs. 29.9%; relative risk [RR] 1.07 [95% CI, 0.88–1.20] p = 0.49). There was borderline improvement in the proportion meeting BP and LDL targets in intervention vs. control (17.1% vs. 12.1% RR 1.40 [95% CI, 0.97–2.03] p = 0.07). The intervention was associated with increased attainment of physical activity targets (87.0% intervention vs. 79.7% control, p = 0.02) and e-health literacy scores (72.6% intervention vs. 64.0% control, p = 0.02). In conclusion, a consumer app integrated with primary health care EHRs was not effective in increasing medication adherence. Borderline improvements in risk factors and modest behavior changes were observed.https://doi.org/10.1038/s41746-020-00325-z |
| spellingShingle | Julie Redfern Genevieve Coorey John Mulley Anish Scaria Lis Neubeck Nashid Hafiz Chris Pitt Kristie Weir Joanna Forbes Sharon Parker Fiona Bampi Alison Coenen Gemma Enright Annette Wong Theresa Nguyen Mark Harris Nick Zwar Clara K. Chow Anthony Rodgers Emma Heeley Katie Panaretto Annie Lau Noel Hayman Tim Usherwood David Peiris A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial npj Digital Medicine |
| title | A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial |
| title_full | A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial |
| title_fullStr | A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial |
| title_full_unstemmed | A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial |
| title_short | A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial |
| title_sort | digital health intervention for cardiovascular disease management in primary care connect randomized controlled trial |
| url | https://doi.org/10.1038/s41746-020-00325-z |
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