Implementation and Effectiveness of "CareAide® App" for People with Cardiometabolic Diseases At a Primary Care Clinic

Primary outcomes

1. Reach

   Time frame: Before the start of intervention

   The absolute number, proportion, and representativeness of individuals who are willing to participate in a given initiative, intervention, or program.

   A proxy for reach was used and defined as the percentage of patients who gave informed consent to participate out of all patients approached.

2. Effectiveness

   Time frame: Before the start of the intervention, and at 24 weeks after the intervention

   The impact of CareAide® app on medication adherence using the Malaysia Medication Adherence Assessment Tool (MyMAAT) score, with 12 points being the minimum score and 60 points being the maximum. Patients are classified as moderate & poor adherence if their score is < 54. Patients have good adherence if their score is ≥ 54.

3. Effectiveness

   Time frame: Before the start of the intervention, and at 24 weeks after the intervention

   The impact of CareAide® app on hypertension, measured by taking the patient's systolic and diastolic blood pressure in mmHg.

4. Effectiveness

   Time frame: Before the start of the intervention, and at 24 weeks after the intervention

   The impact of CareAide® app on type 2 diabetes by measuring the patient's fasting blood glucose (mmol/L) and HbA1c (%).

5. Effectiveness

   Time frame: Before the start of the intervention, and at 24 weeks after the intervention

   The impact of CareAide® app on dyslipidaemia outcomes, measured by taking the patient's total cholesterol (mmol/L), low-density lipoprotein (mmol/L), high density lipoprotein (mmol/L), and triglyceride level (mmol/L).

6. Adoption

   Time frame: Through study completion, an average of 1 year

   The absolute number, proportion, and representativeness of settings and intervention agents (people who deliver the program) who are willing to initiate a program.

   In the case of this study, adoption is measured by finding out the proportion of doctors that agree to deliver the intervention by calculating the number of doctors participated over the total number of doctors involved.

7. Implementation

   Time frame: At three months and at 24 weeks after the intervention

   At the setting level, implementation refers to the intervention agents' fidelity to the various elements of an intervention's protocol, including consistency of delivery as intended and the time and cost of the intervention.

   At the individual level, implementation refers to clients' use of the intervention strategies.

   Implementation will be assessed by exploring engagement with key components of the CareAide® app. Engagement will be assessed by looking through the app analytics data to see the frequency of usage of various app key components.

8. Maintenance

   Time frame: Through study completion, an average of 1 year

   The extent to which a program or policy becomes institutionalized or part of the routine organizational practices and policies.

   At the individual level, maintenance has been defined as the long-term effects of a program on outcomes after 6 or more months after the most recent intervention contact.

   This outcome will measure doctors' and patients' willingness to continue with the app, ease of use, perceived value of each program component, an overall rating of the program, and whether or not they would recommend the app use to others through the means of a self-report section on a questionnaire.

   The System Usability Scale (Brooke, 1986) will also be administered to assess the usability of the App. The scale has a minimum score of 10 and a maximum score of 100. The higher the score, the higher the perceived usability of the CareAide® Medication Adherence Mobile Application.