Table 1.
Recent randomized clinical trials of app-based interventions in CVD patients
| Author, year Country | Number of participants | Duration | Population characteristics | Interventions | Outcomes | p value |
|---|---|---|---|---|---|---|
|
Morawski, [31•] 2018 USA |
412 | 12 weeks |
Mean age: 52 years (SD: NP) Males: 165 (40%) |
Intervention: Medisafe app - BP monitoring/tracking - Medication list - Medication reminders - Medication adherence weekly reports - Medfriend feature, in which the user would allow app access to a family member or friend to view the medication-taking history, receive alerts when the user would miss a medication dose and provide peer-support Control: Usual care |
Co-primary outcome: SBP—mean (SD) I: 140.8 mmHg (15.7) C: 141.2 mmHg (17.3) |
0.78 |
|
Co-primary outcome: Medication adherence MMAS-8 score—mean (SD) I: 6.3 (1.6) C: 5.7 (1.8) |
0.01 | |||||
|
Secondary outcome: SBP/DBP < 140/90 mmHg—n (%) I: 67 (35.8) C: 69 (37.9) |
0.68 | |||||
|
Santo, [32•] 2019 Australia |
163 | 3 months |
Mean age: 57.9 years (SD 8.91) Males: 143 (87.7%) |
Intervention 1: Basic app - Simple non-interactive daily reminders (one-time only), similar to an alarm or text message, for medication-taking at the correct time every day Intervention 2: Advanced app - Interactive and customizable features - Daily reminders that could be snoozed, rescheduled or marked as ‘taken’ or ‘missed’ - Default settings for the reminders to occur up to 3 times at 10-min intervals - Medication refill reminders - Medication adherence statistics - Ability to export and share information with others - Ability to alert other people if the participant missed a medication dose Control: Usual care |
Primary outcome: Medication adherence MMAS-8 score—mean (95% CI) I: 7.11 (6.90–7.31) C: 6.63 (6.35–6.92) |
0.008 |
|
Secondary outcome: SBP—mean (SD) I: 125.0 (17.05) C: 126.0 (19.12) |
0.773 | |||||
|
Secondary outcome: DBP—mean (SD) I: 80.2 (8.76) C: 81.1 (10.47) |
0.592 | |||||
|
Secondary outcome: Total cholesterol—mean (SD) I: 3.60 (0.90) C: 3.60 (0.84) |
0.990 | |||||
|
Secondary outcome: LDL cholesterol—mean (SD) I: 1.62 (0.75) C: 1.68 (0.70) |
0.692 | |||||
|
Australia |
934 | 12 months |
Mean age: 67.0 years (SD 8.1) Males: 719 (77%) |
Intervention: CONNECT website/app - Integration with patient’s electronic health record with the ability to view personal health information, such as prescribed medicines, test results, BP and weight - Heart age calculator - Simple medication and lifestyle reminders - Appointment reminders - Motivational message prompts, e.g. salt reduction tips - Interactive goal setting - Peer forums Control: Usual care |
Medication adherence—%* I: 32.8 C: 29.9 |
0.485 |
|
SBP—mean (SD) I: 136.4 (17.6) C: 136.3 (16.1) |
0.921 | |||||
|
LDL cholesterol—mean (SD) I: 2.40 (1.00) C: 2.50 (0.90) |
0.240 | |||||
|
BMI—mean (SD) I: 29.7 (5.70) C: 29.4 (5.00) |
0.508 | |||||
|
Physically active—% I: 87 C: 79.7 |
0.016 | |||||
|
Current smoker—% I: 8.1 C: 12 |
0.087 | |||||
|
eHealth literacy (eHEALS score)—mean (SD) I: 28.3 (6.3) C: 26.4 (7.5) |
0.002 |
BMI, body mass index; C, control group; CI, confidence interval; DBP, diastolic blood pressure; I, intervention group; LDL, low-density lipoprotein; n, number; NP, not provided; SBP, systolic blood pressure; SD, standard deviation
*Medication adherence defined as taking BP and cholesterol medications on ≥ 80% of days