A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial
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...
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| Published in | NPJ digital medicine Vol. 3; no. 1; pp. 117 - 9 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
Nature Publishing Group UK
10.09.2020
Nature Publishing Group Nature Portfolio |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2398-6352 2398-6352 |
| DOI | 10.1038/s41746-020-00325-z |
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| 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. |
|---|---|
| AbstractList | 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. 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. 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.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. 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. 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] = 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] = 0.07). The intervention was associated with increased attainment of physical activity targets (87.0% intervention vs. 79.7% control, = 0.02) and e-health literacy scores (72.6% intervention vs. 64.0% control, = 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. |
| ArticleNumber | 117 |
| Author | Usherwood, Tim Coenen, Alison Nguyen, Theresa Weir, Kristie Rodgers, Anthony Enright, Gemma Bampi, Fiona Forbes, Joanna Hayman, Noel Heeley, Emma Peiris, David Scaria, Anish Panaretto, Katie Mulley, John Neubeck, Lis Parker, Sharon Chow, Clara K. Hafiz, Nashid Wong, Annette Zwar, Nick Lau, Annie Harris, Mark Redfern, Julie Pitt, Chris Coorey, Genevieve |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32964140$$D View this record in MEDLINE/PubMed |
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| PublicationTitle | NPJ digital medicine |
| PublicationTitleAbbrev | npj Digit. Med |
| PublicationTitleAlternate | NPJ Digit Med |
| PublicationYear | 2020 |
| Publisher | Nature Publishing Group UK Nature Publishing Group Nature Portfolio |
| Publisher_xml | – name: Nature Publishing Group UK – name: Nature Publishing Group – name: Nature Portfolio |
| References | SantoKMedication reminder applications to improve adherence in coronary heart disease: a randomised clinical trialHeart20191053233291:CAS:528:DC%2BC1MXhs1Gqu73E10.1136/heartjnl-2018-313479 OsborneRHBatterhamRWElsworthGRHawkinsMBuchbinderRThe grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ)BMC Public Health20131310.1186/1471-2458-13-658 RedfernJDevelopment of a set of mobile phone text messages designed for prevention of recurrent cardiovascular eventsEur. J. Prev. Cardiol.2014214924991:STN:280:DC%2BC38nkt1Slsw%3D%3D10.1177/2047487312449416 WestRHajekPSteadLStapletonJOutcome criteria in smoking cessation trials: proposal for a common standardAddiction200510029930310.1111/j.1360-0443.2004.00995.x World Heath Organization. Cardiovascular diseases (CVDs) fact sheet. https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). Accessed 28 May 2019. SundströmJGullikssonGWirénMSynergistic effects of blood pressure-lowering drugs and statins: systematic review and meta-analysisBMJ Evid. Based Med.2018236410.1136/bmjebm-2017-110888 SparrowRTEffectiveness of interventions aimed at increasing statin-prescribing rates in primary cardiovascular disease prevention: a systematic review of randomized clinical trialsJAMA Cardiol.201941160116910.1001/jamacardio.2019.3066 National Vascular Disease Prevention Alliance. Guidelines for the management of absolute cardiovascular disease risk (2012). http://www.cvdcheck.org.au/pdf/Absolute_CVD_Risk_Full_Guidelines.pdf. Accessed 30 March 2020. NeubeckLThe mobile revolution—using smartphone apps to prevent cardiovascular diseaseNat. Rev. Cardiol.20151235036010.1038/nrcardio.2015.34 IslamSMMobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysisOpen Heart2019610.1136/openhrt-2019-001017 LauAYSArguelADennisSLiawSTCoieraEWhy didn’t it work?” Lessons from a Randomized Controlled Trial of a Web-based Personally Controlled Health Management System for Adults with AsthmaJ. Med. Internet Res.20151710.2196/jmir.4734 ChowCKEffect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease: a randomized clinical trialJ. Am. Med Assoc.2015314125512631:CAS:528:DC%2BC28XitFShsrY%3D10.1001/jama.2015.10945 NeubeckLDevelopment of an integrated e-health tool for people with, or at high risk of, cardiovascular disease: The Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) web applicationInt. J. Med. Inf.201696243710.1016/j.ijmedinf.2016.01.009 AndersonJL2011 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 GuidelinesCirculation2011123e426e57921444888 RedfernJFactors influencing engagement, perceived usefulness and behavioral mechanisms associated with a text message support programPLoS ONE20161110.1371/journal.pone.0163929 ChewDPNational Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromesMed. J. Aust.201620512813310.5694/mja16.00368 ChowCKAssociation of diet, exercise, and smoking modification with risk of early cardiovascular events after acute coronary syndromesCirculation201012175075810.1161/CIRCULATIONAHA.109.891523 CanawayRGathering data for decisions: best practice use of primary care electronic records for researchMed. J. Aust.2019210S12S1610.5694/mja2.50026 TutiTA systematic review of electronic audit and feedback: intervention effectiveness and use of behaviour change theoryImplement. Sci.2017126110.1186/s13012-017-0590-z GreenhalghTBeyond adoption: a new framework for theorizing and evaluating nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability of health and care technologiesJ. Med. Internet Res.20171910.2196/jmir.8775 World Health Organisation. Global physical activity questionnaire (GPAQ) analysis guide. https://www.who.int/ncds/surveillance/steps/resources/GPAQ_Analysis_Guide.pdf. Accessed 14 June 2013. 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Outcomes20158879510.1161/CIRCOUTCOMES.114.001235 CooreyGPersuasive design features within a consumer-focused eHealth intervention integrated with the electronic health record: a mixed methods study of effectiveness and acceptabilityPLoS ONE2019141:CAS:528:DC%2BC1MXhsFCqs77K10.1371/journal.pone.0218447 LeslieKHMcCowanCPellJPAdherence to cardiovascular medication: a review of systematic reviewsJ. Pub. Health201841e84e9410.1093/pubmed/fdy088 Statista. Number of smartphone users worldwide from 2016 to 2021 (in billions). https://www.statista.com/statistics/330695/number-of-smartphone-users-worldwide/. Accessed 26 August 2019. Vogels, E. A. Millennials stand out for their technology use, but older generations also embrace digital life. Pew Research Center FactTank 2019. https://www.pewresearch.org/fact-tank/2019/09/09/us-generations-technology-use/. Accessed 20 June 2020. StephensonJImrieJWhy do we need randomised controlled trials to assess behavioural interventions?Br. Med. J.19983166116131:STN:280:DyaK1c7nvFChsQ%3D%3D10.1136/bmj.316.7131.611 AschDAEffect of financial incentives to physicians, patients, or both on lipid levels: a randomized clinical trialJ. Am. Med. Assoc.2015314192619351:CAS:528:DC%2BC28XjsFyitro%3D10.1001/jama.2015.14850 Grand View Research. Electronic health records (EHR) market analysis by product (client server-based, web-based), by type (acute, ambulatory, post-acute) by end-use (hospitals, ambulatory care), and segment forecasts, 2018–2025. https://www.grandviewresearch.com/industry-analysis/electronic-health-records-ehr-market. Accessed 28th May 2019. National Heart Foundation of Australia; Cardiac Society of Australia and New Zealand. Reducing risk in heart disease: an expert guide to clinical practice for secondary prevention of coronary heart disease. https://www.heartfoundation.org.au/images/uploads/publications/Reducing-risk-in-heart-disease.pdf. Accessed 19 December 2019. PerelPReducing premature cardiovascular morbidity and mortality in people with atherosclerotic vascular disease: the World Heart Federation roadmap for secondary prevention of cardiovascular diseaseGlob. Heart2015109911010.1016/j.gheart.2015.04.003 GreenBBEffectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trialJ. Am. Med. Assoc.2008299285728671:CAS:528:DC%2BD1cXnvV2ltLs%3D10.1001/jama.299.24.2857 R Canaway (325_CR13) 2019; 210 KH Leslie (325_CR16) 2018; 41 325_CR27 JL Anderson (325_CR3) 2011; 123 BB Green (325_CR8) 2008; 299 SM Islam (325_CR17) 2019; 6 D Peiris (325_CR9) 2015; 8 L Neubeck (325_CR7) 2015; 12 J Stephenson (325_CR22) 1998; 316 R Viney (325_CR33) 2011; 14 J Redfern (325_CR29) 2014; 21 J Redfern (325_CR26) 2014; 4 325_CR6 J Redfern (325_CR30) 2016; 11 CD Norman (325_CR35) 2016; 8 325_CR1 L Neubeck (325_CR28) 2016; 96 T Tuti (325_CR18) 2017; 12 J Sundström (325_CR15) 2018; 23 P Perel (325_CR5) 2015; 10 K Santo (325_CR10) 2019; 105 CK Chow (325_CR11) 2015; 314 325_CR14 CK Chow (325_CR4) 2010; 121 325_CR12 325_CR34 AYS Lau (325_CR25) 2015; 17 325_CR32 RT Sparrow (325_CR19) 2019; 4 G Coorey (325_CR23) 2019; 14 DP Chew (325_CR2) 2016; 205 RH Osborne (325_CR24) 2013; 13 DA Asch (325_CR20) 2015; 314 R West (325_CR31) 2005; 100 T Greenhalgh (325_CR21) 2017; 19 |
| References_xml | – reference: Statista. Number of smartphone users worldwide from 2016 to 2021 (in billions). https://www.statista.com/statistics/330695/number-of-smartphone-users-worldwide/. Accessed 26 August 2019. – reference: LeslieKHMcCowanCPellJPAdherence to cardiovascular medication: a review of systematic reviewsJ. Pub. Health201841e84e9410.1093/pubmed/fdy088 – reference: ChewDPNational Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromesMed. J. Aust.201620512813310.5694/mja16.00368 – reference: ChowCKEffect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease: a randomized clinical trialJ. Am. Med Assoc.2015314125512631:CAS:528:DC%2BC28XitFShsrY%3D10.1001/jama.2015.10945 – reference: NeubeckLThe mobile revolution—using smartphone apps to prevent cardiovascular diseaseNat. Rev. Cardiol.20151235036010.1038/nrcardio.2015.34 – reference: Vogels, E. A. Millennials stand out for their technology use, but older generations also embrace digital life. Pew Research Center FactTank 2019. https://www.pewresearch.org/fact-tank/2019/09/09/us-generations-technology-use/. Accessed 20 June 2020. – reference: IslamSMMobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysisOpen Heart2019610.1136/openhrt-2019-001017 – reference: GreenhalghTBeyond adoption: a new framework for theorizing and evaluating nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability of health and care technologiesJ. Med. Internet Res.20171910.2196/jmir.8775 – reference: StephensonJImrieJWhy do we need randomised controlled trials to assess behavioural interventions?Br. Med. J.19983166116131:STN:280:DyaK1c7nvFChsQ%3D%3D10.1136/bmj.316.7131.611 – reference: NormanCDSkinnerHAeHEALS: the ehealth literacy scaleJ. Med. Internet Res.2016810.2196/jmir.8.4.e27 – reference: National Vascular Disease Prevention Alliance. Guidelines for the management of absolute cardiovascular disease risk (2012). http://www.cvdcheck.org.au/pdf/Absolute_CVD_Risk_Full_Guidelines.pdf. Accessed 30 March 2020. – reference: NeubeckLDevelopment of an integrated e-health tool for people with, or at high risk of, cardiovascular disease: The Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) web applicationInt. J. Med. Inf.201696243710.1016/j.ijmedinf.2016.01.009 – reference: AndersonJL2011 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 GuidelinesCirculation2011123e426e57921444888 – reference: ChowCKAssociation of diet, exercise, and smoking modification with risk of early cardiovascular events after acute coronary syndromesCirculation201012175075810.1161/CIRCULATIONAHA.109.891523 – reference: RedfernJFactors influencing engagement, perceived usefulness and behavioral mechanisms associated with a text message support programPLoS ONE20161110.1371/journal.pone.0163929 – reference: GreenBBEffectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trialJ. Am. Med. Assoc.2008299285728671:CAS:528:DC%2BD1cXnvV2ltLs%3D10.1001/jama.299.24.2857 – reference: RedfernJA randomised controlled trial of a consumer-focused e-health strategy for cardiovascular risk management in primary care: the Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) study protocolBMJ Open2014410.1136/bmjopen-2013-004523 – reference: LauAYSArguelADennisSLiawSTCoieraEWhy didn’t it work?” Lessons from a Randomized Controlled Trial of a Web-based Personally Controlled Health Management System for Adults with AsthmaJ. Med. Internet Res.20151710.2196/jmir.4734 – reference: PerelPReducing premature cardiovascular morbidity and mortality in people with atherosclerotic vascular disease: the World Heart Federation roadmap for secondary prevention of cardiovascular diseaseGlob. Heart2015109911010.1016/j.gheart.2015.04.003 – reference: National Heart Foundation of Australia; Cardiac Society of Australia and New Zealand. Reducing risk in heart disease: an expert guide to clinical practice for secondary prevention of coronary heart disease. https://www.heartfoundation.org.au/images/uploads/publications/Reducing-risk-in-heart-disease.pdf. Accessed 19 December 2019. – reference: SantoKMedication reminder applications to improve adherence in coronary heart disease: a randomised clinical trialHeart20191053233291:CAS:528:DC%2BC1MXhs1Gqu73E10.1136/heartjnl-2018-313479 – reference: Grand View Research. Electronic health records (EHR) market analysis by product (client server-based, web-based), by type (acute, ambulatory, post-acute) by end-use (hospitals, ambulatory care), and segment forecasts, 2018–2025. https://www.grandviewresearch.com/industry-analysis/electronic-health-records-ehr-market. Accessed 28th May 2019. – reference: SparrowRTEffectiveness of interventions aimed at increasing statin-prescribing rates in primary cardiovascular disease prevention: a systematic review of randomized clinical trialsJAMA Cardiol.201941160116910.1001/jamacardio.2019.3066 – reference: World Health Organisation. Global physical activity questionnaire (GPAQ) analysis guide. https://www.who.int/ncds/surveillance/steps/resources/GPAQ_Analysis_Guide.pdf. Accessed 14 June 2013. – reference: OsborneRHBatterhamRWElsworthGRHawkinsMBuchbinderRThe grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ)BMC Public Health20131310.1186/1471-2458-13-658 – reference: World Heath Organization. Cardiovascular diseases (CVDs) fact sheet. https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). Accessed 28 May 2019. – reference: PeirisDEffect of a computer-guided, quality improvement program for cardiovascular disease risk management in primary health care: the treatment of cardiovascular risk using electronic decision support cluster-randomized trialCirc. Cardiovasc. Qual. Outcomes20158879510.1161/CIRCOUTCOMES.114.001235 – reference: AschDAEffect of financial incentives to physicians, patients, or both on lipid levels: a randomized clinical trialJ. Am. Med. Assoc.2015314192619351:CAS:528:DC%2BC28XjsFyitro%3D10.1001/jama.2015.14850 – reference: RedfernJDevelopment of a set of mobile phone text messages designed for prevention of recurrent cardiovascular eventsEur. J. Prev. Cardiol.2014214924991:STN:280:DC%2BC38nkt1Slsw%3D%3D10.1177/2047487312449416 – reference: VineyRTime trade-off derived EQ-5D weights for AustraliaValue Health20111492893610.1016/j.jval.2011.04.009 – reference: TutiTA systematic review of electronic audit and feedback: intervention effectiveness and use of behaviour change theoryImplement. Sci.2017126110.1186/s13012-017-0590-z – reference: CooreyGPersuasive design features within a consumer-focused eHealth intervention integrated with the electronic health record: a mixed methods study of effectiveness and acceptabilityPLoS ONE2019141:CAS:528:DC%2BC1MXhsFCqs77K10.1371/journal.pone.0218447 – reference: WestRHajekPSteadLStapletonJOutcome criteria in smoking cessation trials: proposal for a common standardAddiction200510029930310.1111/j.1360-0443.2004.00995.x – reference: SundströmJGullikssonGWirénMSynergistic effects of blood pressure-lowering drugs and statins: systematic review and meta-analysisBMJ Evid. Based Med.2018236410.1136/bmjebm-2017-110888 – reference: CanawayRGathering data for decisions: best practice use of primary care electronic records for researchMed. J. Aust.2019210S12S1610.5694/mja2.50026 – volume: 123 start-page: e426 year: 2011 ident: 325_CR3 publication-title: Circulation – volume: 41 start-page: e84 year: 2018 ident: 325_CR16 publication-title: J. Pub. Health doi: 10.1093/pubmed/fdy088 – volume: 12 start-page: 61 year: 2017 ident: 325_CR18 publication-title: Implement. Sci. doi: 10.1186/s13012-017-0590-z – volume: 19 year: 2017 ident: 325_CR21 publication-title: J. Med. Internet Res. doi: 10.2196/jmir.8775 – volume: 12 start-page: 350 year: 2015 ident: 325_CR7 publication-title: Nat. Rev. Cardiol. doi: 10.1038/nrcardio.2015.34 – ident: 325_CR27 – volume: 8 start-page: 87 year: 2015 ident: 325_CR9 publication-title: Circ. Cardiovasc. Qual. Outcomes doi: 10.1161/CIRCOUTCOMES.114.001235 – volume: 21 start-page: 492 year: 2014 ident: 325_CR29 publication-title: Eur. J. Prev. Cardiol. doi: 10.1177/2047487312449416 – volume: 4 start-page: 1160 year: 2019 ident: 325_CR19 publication-title: JAMA Cardiol. doi: 10.1001/jamacardio.2019.3066 – volume: 314 start-page: 1926 year: 2015 ident: 325_CR20 publication-title: J. Am. Med. Assoc. doi: 10.1001/jama.2015.14850 – volume: 210 start-page: S12 year: 2019 ident: 325_CR13 publication-title: Med. J. Aust. doi: 10.5694/mja2.50026 – ident: 325_CR34 – volume: 10 start-page: 99 year: 2015 ident: 325_CR5 publication-title: Glob. Heart doi: 10.1016/j.gheart.2015.04.003 – ident: 325_CR32 – volume: 314 start-page: 1255 year: 2015 ident: 325_CR11 publication-title: J. Am. Med Assoc. doi: 10.1001/jama.2015.10945 – volume: 14 start-page: 928 year: 2011 ident: 325_CR33 publication-title: Value Health doi: 10.1016/j.jval.2011.04.009 – ident: 325_CR1 – volume: 96 start-page: 24 year: 2016 ident: 325_CR28 publication-title: Int. J. Med. Inf. doi: 10.1016/j.ijmedinf.2016.01.009 – volume: 23 start-page: 64 year: 2018 ident: 325_CR15 publication-title: BMJ Evid. Based Med. doi: 10.1136/bmjebm-2017-110888 – volume: 8 year: 2016 ident: 325_CR35 publication-title: J. Med. Internet Res. doi: 10.2196/jmir.8.4.e27 – volume: 205 start-page: 128 year: 2016 ident: 325_CR2 publication-title: Med. J. Aust. doi: 10.5694/mja16.00368 – volume: 14 year: 2019 ident: 325_CR23 publication-title: PLoS ONE doi: 10.1371/journal.pone.0218447 – volume: 6 year: 2019 ident: 325_CR17 publication-title: Open Heart doi: 10.1136/openhrt-2019-001017 – volume: 100 start-page: 299 year: 2005 ident: 325_CR31 publication-title: Addiction doi: 10.1111/j.1360-0443.2004.00995.x – volume: 11 year: 2016 ident: 325_CR30 publication-title: PLoS ONE doi: 10.1371/journal.pone.0163929 – volume: 13 year: 2013 ident: 325_CR24 publication-title: BMC Public Health doi: 10.1186/1471-2458-13-658 – volume: 121 start-page: 750 year: 2010 ident: 325_CR4 publication-title: Circulation doi: 10.1161/CIRCULATIONAHA.109.891523 – volume: 4 year: 2014 ident: 325_CR26 publication-title: BMJ Open doi: 10.1136/bmjopen-2013-004523 – ident: 325_CR12 – ident: 325_CR6 – volume: 105 start-page: 323 year: 2019 ident: 325_CR10 publication-title: Heart doi: 10.1136/heartjnl-2018-313479 – ident: 325_CR14 – volume: 17 year: 2015 ident: 325_CR25 publication-title: J. 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| Title | A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial |
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