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Determining whether cardiac care outcomes could be improved with a digital health app linked to primary care records was the focus of world-first clinical research led by the George Institute for Global Health. 

Published in the npj Digital Medicine journal, the ‘CONNECT’ project was a randomised controlled trial involving patients with or at risk of cardiovascular disease. 

In the large general practice study of 934 people, some participants received an interactive app that was populated and refreshed with GP medical records, diagnoses and medications via Extensia’s RecordPoint, plus risk calculators, motivational messages and lifestyle goal tracking. Members of the control group received their usual healthcare.  

Cardiovascular disease is responsible for most of the burden of non-communicable diseases globally, accounting for over 17 million deaths in 2016. International guidelines place adherence to prevention medication and healthy lifestyles at the core of risk management, and primary and secondary prevention recommendations. 

But the George Institute’s Professor David Peiris and the University of Sydney’s Professor Julie Redfern wrote in a Q&A that many people simply don’t adhere to the advice.  

“The reasons for this are complex and many barriers exist at the health system, provider and patient levels. In the CONNECT trial we wanted to see if a patient-focused app that uploaded information from a patient’s GP records and gave them support on how to optimise their cardiovascular health may lead to better use of recommended medicines and control of cardiovascular risk factors.” 

Digital health has tremendous potential to improve patients’ engagement in the management of their own health. However, research lags behind the rapid emergence and adoption of the technologies targeting health-related behaviours.  

To address the knowledge shortfall, researchers followed the CONNECT participants’ progress for one year to see if those with access to the app had achieved better control of their blood pressure and cholesterol, and increased their use of recommended medicines. 

The trial, which was conducted prior to the COVID-19 pandemic, observed some improvements, finding there was an increase in self-reported physical activity and an improvement in ehealth literacy. The proportion of people achieving blood pressure and cholesterol targets rose from 12 per cent to 17 per cent, but researchers said that may have been a chance finding.  

Patient attitudes to the app were largely very positive, according to the researchers, with 73 per cent reporting they had benefited from the personalised cardiovascular disease risk score. Almost 70 per cent said they liked the goal tracking, while more than half (52 per cent) benefited from the risk factor self-monitoring and 54 per cent liked the motivational health tips. 

The researchers found that apps like CONNECT likely do have a role to play in more actively engaging patients in their healthcare, but they need to be combined with other strategies to support patients and care providers to achieve better outcomes. 

Trialing the effectiveness of digital health technologies, such as Extensia’s, ensures software is created and evolved in alignment with the best research into patient behaviors, and how technology can improve health and save lives. 

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