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.

数字健康应用程序 (App) 有潜力改善健康行为和结果。我们的目的是检查与初级保健电子健康记录 (EHR) 相关的消费者网络应用程序的有效性。CONNECT 是一项多中心随机对照试验，涉及从初级保健机构招募的患有心血管疾病 (CVD) 或有心血管疾病 (CVD) 风险的患者（临床试验注册 ACTRN12613000715774）。干预参与者收到了一个交互式应用程序，该应用程序预先填充并更新了 EHR 风险因素数据、诊断和药物。交互式风险计算器、激励信息和生活方式目标跟踪也包括在内。对照组接受常规医疗保健。主要结局是遵守指南推荐的药物治疗（血压 (BP) 和他汀类药物治疗天数≥80%）。次要结果包括风险因素目标的实现和电子健康素养。总共招募了 934 名患者；平均年龄 67.6 (±8.1) 岁。12 个月时，使用推荐药物天数 >80% 的比例总体较低，组间无差异（32.8% 对比 29.9%；相对风险 [RR] 1.07 [95% CI, 0.88–1.20] p  = 0.49）。与对照组相比，干预组中达到血压和 LDL 目标的比例略有改善（17.1% vs. 12.1% RR 1.40 [95% CI, 0.97–2.03] p = 0.07 ）  。干预与身体活动目标的实现率提高相关（87.0% 干预 vs. 79.7% 对照，p  = 0.02）和电子健康素养得分（72.6% 干预 vs. 64.0% 对照，p  = 0.02）。总之，与初级卫生保健 EHR 集成的消费者应用程序并不能有效提高药物依从性。观察到风险因素的临界改善和适度的行为改变。