A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial

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...

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Autores principales: 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
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2020
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Computer applications to medicine. Medical informatics
R858-859.7
Acceso en línea:https://doaj.org/article/5610c9a019db40ccbb997a25d714f092
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spelling oai:doaj.org-article:5610c9a019db40ccbb997a25d714f0922021-12-02T14:58:42ZA digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial10.1038/s41746-020-00325-z2398-6352https://doaj.org/article/5610c9a019db40ccbb997a25d714f0922020-09-01T00:00:00Zhttps://doi.org/10.1038/s41746-020-00325-zhttps://doaj.org/toc/2398-6352Abstract 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.Julie RedfernGenevieve CooreyJohn MulleyAnish ScariaLis NeubeckNashid HafizChris PittKristie WeirJoanna ForbesSharon ParkerFiona BampiAlison CoenenGemma EnrightAnnette WongTheresa NguyenMark HarrisNick ZwarClara K. ChowAnthony RodgersEmma HeeleyKatie PanarettoAnnie LauNoel HaymanTim UsherwoodDavid PeirisNature PortfolioarticleComputer applications to medicine. Medical informaticsR858-859.7ENnpj Digital Medicine, Vol 3, Iss 1, Pp 1-9 (2020)
institution DOAJ
collection DOAJ
language EN
topic Computer applications to medicine. Medical informatics
R858-859.7
spellingShingle Computer applications to medicine. Medical informatics
R858-859.7
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
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.
format article
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
title 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_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_sort digital health intervention for cardiovascular disease management in primary care (connect) randomized controlled trial
publisher Nature Portfolio
publishDate 2020
url https://doaj.org/article/5610c9a019db40ccbb997a25d714f092
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