Table 5.
Selected app-driven digital health interventions for primary care.
| First author, year | Study design | Description of technology | Sample size | Selected outcomes |
| Bennett, 2018 [35] | RCTa | App using IVRb and SMS text messaging to collect patient behavior change data and weight via a smart scale, provide tailored patient feedback based on goal progression, and generate EHRc counseling recommendations for clinicians. | 351 patients | −4.4 kg (95% CI −5.5 to −3.3) weight loss at 6 months (P<.001); −3.8 kg (95% CI −5.0 to −2.5) weight loss at 12 months (P<.001). Participants completing ≥80% of interactions lost significantly more weight than less engaged participants (P<.01). |
| Brayboy, 2016 [45] | Pre-post | iPhone-compatible app for providing trusted, age-appropriate, straightforward sexual health information and resources to teenage girls. | 20 teenage girls | 3.4%-4.2% improvement in sexual health topic knowledge. 58.8% increase in the perception that they or other teenage girls would use the app (P<.001). |
| Dahne, 2019 [64] | RCT | Self-help app adaptation of Brief Behavioral Apptivation, including education, identification of values, daily mood monitoring, and social support including gamification, to reinforce continued use. | 52 patients | 63% greater decrease on BDI-IId assessment after treatment compared with usual care. 70% of participants continued to use the app 1 month after enrollment, and 50% continued to use it at 2 months. |
| Gustafson, 2014 [99] | RCT | Smartphone app to support alcoholism recovery using alerts for trigger locations, audio-guided relaxation, PROe measurement, and clinician notification, as well as a panic button for contacting support persons. | 349 patients | 1.37 (95% CI 0.46-2.27) fewer risky drinking days than controls over 12 months (P=.003). OR 1.65 (95% CI 1.05-2.57) for abstinence prevalence over 12 months (P=.03). |
| Leddy, 2019 [140] | RCT | Home smartphone urinalysis test to complete proteinuria screening for HTNf management. SMS text message link for downloading the app, obtaining the home testing kit, and receiving PCPg notification of abnormal results. | 999 patients | 10.9% increase in proteinuria screening completion (P<.001). 89% of home test patients preferred home testing over a visit to the physician’s office. |
| Lv, 2017 [149] | Pre-post | Dashboard of patient’s personalized action plan, treatment goals, and self-monitoring data combined with a wireless BPh monitor, smartphone, study app, pedometer, and web messaging system. | 147 patients | 55.9% increase in the proportion of patients meeting office BP goals (<140/90 mmHg) at 6 months (P<.001). 46.2% increase in the proportion of patients meeting home BP goals (<135/85 mmHg) at 6 months (P<.001). |
| Ofili, 2018 [176] | Pre-post | App with diabetes curriculum, goal identification and tracking, connectivity to consumer devices (eg, activity monitors), and health coach consultation. | 287 patients | Improvements in SBPi (6 mmHg), blood glucose (15 mg/dL), and physical activity (0.56 miles/day) at 12 weeks (all P<.01), which continued through 52 weeks. |
| Yu, 2018 [249] | Pre-post | App delivering a guided cognitive behavioral program for generalized anxiety disorder along with in-app coach pairing and messaging. | 63 patients | 3.6-point mean reduction on GAD-7j over 2 months for patients with baseline GAD-7 ≥8 (P<.001). |
aRCT: randomized controlled trial.
bIVR: interactive voice response.
cEHR: electronic health record.
dBDI-II: Beck Depression Inventory II.
ePRO: patient-reported outcome.
fHTN: hypertension.
gPCP: primary care provider.
hBP: blood pressure.
iSBP: systolic blood pressure.
jGAD-7: Generalized Anxiety Disorder-7.