23 Evaluating the impact of a fully digital behaviour change tool across physical and mental health outcomes in primary care patients with a history of heart disease

<h3>Background</h3> In-person cardiac rehabilitation (CR) programmes are typically unable to support behaviour change over the long term (e.g. beyond 12 weeks), and rarely incorporate mental wellbeing support. Digital self-management services have the potential to provide a low-cost scalable solution that supports patients’ physical and mental health &amp; long-term behaviour change. <h3>Aim</h3> To evaluate the potential of a digital self-management tool to improve physical and mental health outcomes in primary care patients with a history of stroke/heart disease. <h3>Methods</h3> This was a real-world evaluation using Holly Health (HH), a fully digital personalised behaviour change app for physical and mental health, deployed in &gt;150 NHS GP practices. We analysed a subset of primary care patients (n=59) who reported either ‘stroke’ or ‘heart disease’ as medical conditions during signup. A paired samples t-test analysis measured self-reported health changes from baseline to week 8 post-HH use. A sensitivity analysis was conducted for patients with low-to-medium baseline scores across health outcomes (average n= 40). Qualitative feedback was collected during the 8-week health survey. <h3>Results</h3> Statistically significant improvements (p&lt;0.05 to p&lt;0.01) were observed in self-reported energy levels, exercise (cardiovascular, flexibility and strength), stress, and 3/4 items from the ONS-4 personal wellbeing questionnaire (life satisfaction, happiness and anxiety). Sensitivity analyses also revealed improvements in self-management skills, long-term mindset and drinking habits (p&lt;0.01). Qualitative feedback suggested that patients find HH useful and motivating to create health habits. Additionally, 33% of patients reported an improvement in medical conditions after using HH. <h3>Conclusions</h3> Results from this evaluation reveal the potential of fully digital self-management services like HH that provide tailored behaviour change support to improve patient outcomes. Further studies are needed to evaluate the impact of these services as part of secondary care CR programmes and to measure longer-term outcomes.