Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 10:3:117.
doi: 10.1038/s41746-020-00325-z. eCollection 2020.

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

Julie Redfern  1   2 , Genevieve Coorey  2   3 , John Mulley  2 , Anish Scaria  2 , Lis Neubeck  4 , Nashid Hafiz  1 , Chris Pitt  2 , Kristie Weir  2 , Joanna Forbes  2 , Sharon Parker  4 , Fiona Bampi  5 , Alison Coenen  2 , Gemma Enright  1 , Annette Wong  6 , Theresa Nguyen  2 , Mark Harris  7 , Nick Zwar  8   9 , Clara K Chow  1   2 , Anthony Rodgers  2 , Emma Heeley  2 , Katie Panaretto  10 , Annie Lau  11 , Noel Hayman  12 , Tim Usherwood  1   2   13 , David Peiris  2
Affiliations

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

Julie Redfern et al. NPJ Digit Med. .

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.

Keywords: Ischaemia; Preventive medicine.

PubMed Disclaimer

Conflict of interest statement

Competing interestsGeorge Health Enterprises, the social enterprise arm of The George Institute for Global Health is involved in commercialization activities for the SMARThealth suite of products which includes the CONNECT app. None of the authors have a financial interest in these planned products.

Figures

Fig. 1
Fig. 1. Participant flow.
GP general practitioner.
Fig. 2
Fig. 2
Intervention screen shots.
Fig. 3
Fig. 3. Trial outcomes.
CI confidence interval, RR relative risk, BP blood pressure, LDL low-density lipoprotein cholesterol, BMI body mass index, kg kilogram, m meter.
Fig. 4
Fig. 4. Sub-group analyses for the primary outcome.
yrs years, eHEALS eHealth literacy score, CVD cardiovascular disease.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Heath Organization. Cardiovascular diseases (CVDs) fact sheet. https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-disea.... Accessed 28 May 2019.
    1. Chew DP, et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromes. Med. J. Aust. 2016;205:128–133. doi: 10.5694/mja16.00368. - DOI - PubMed
    1. Anderson JL, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-st-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;123:e426–e579. - PubMed
    1. Chow CK, et al. Association of diet, exercise, and smoking modification with risk of early cardiovascular events after acute coronary syndromes. Circulation. 2010;121:750–758. doi: 10.1161/CIRCULATIONAHA.109.891523. - DOI - PubMed
    1. Perel P, et al. Reducing premature cardiovascular morbidity and mortality in people with atherosclerotic vascular disease: the World Heart Federation roadmap for secondary prevention of cardiovascular disease. Glob. Heart. 2015;10:99–110. doi: 10.1016/j.gheart.2015.04.003. - DOI - PubMed