The number of community-dwelling elderly patients with multimorbidity of the "three highs" (hypertension, type 2 diabetes, and hyperlipidemia) is increasing annually in China. These patients face substantial challenges, including polypharmacy and difficulties in behavioral self-management, and traditional chronic disease follow-up models are insufficient to meet their needs for integrated care. Although intelligent voice outbound call systems have demonstrated preliminary feasibility in single-disease management, randomized controlled trials specifically targeting integrated interventions for patients with these three concurrent conditions remain scarce, and their effectiveness is still unclear.

To investigate the effectiveness of an intelligent voice outbound call system as an adjunct to traditional intervention on health cognition, behavioral adherence, and clinical indicators in community-dwelling elderly patients with "three highs" comorbidity.

A total of 200 patients with "three highs" comorbidity who attended outpatient clinics at the Fangzhuang Community Health Service Center and Xiluoyuan Community Health Service Center in Fengtai District, Beijing, from January to March 2025 were enrolled. Using a block randomization method with a computer-generated random sequence, they were assigned at a 1∶1 ratio to an intervention group and a control group, with 100 patients in each group. The control group received routine community-based chronic disease management, while the intervention group received additional intelligent voice outbound call-assisted management on top of the usual care. Voice follow-ups were conducted once per quarter over the 12-month intervention period, covering health knowledge quizzes, self-monitoring reminders, lifestyle guidance, and medication confirmation. After each call, patients who answered incorrectly received instant text messages containing their personalized control targets; those who could not be reached were manually re-contacted by the family doctor team. Outcome measures included health cognition (awareness rates of blood pressure, blood glucose, and lipid control targets), behavioral adherence (adherence to blood pressure monitoring, blood glucose monitoring, dietary management, physical activity, and regular medication), and clinical indicators (BMI, WHR, SBP, DBP, FPG, HbA_1c, TC, TG, and LDL-C).

After the intervention, the intervention group demonstrated significantly higher awareness rates of blood pressure, blood glucose, and lipid control targets, as well as better adherence to blood pressure monitoring, blood glucose monitoring, dietary management, and physical activity compared with the control group (all P<0.05). Furthermore, the intervention group had significantly lower BMI, WHR, DBP, HbA_1c, and TC levels than the control group (all P<0.05).

The intelligent voice outbound call system, when used as an adjunct to usual care, can improve health cognition, behavioral adherence, and several clinical indicators, including BMI, WHR, DBP, and HbA_1c, in community-dwelling elderly patients with "three highs" comorbidity. This model shows promise as an efficient auxiliary tool for community-based chronic disease management, although its long-term effects require further validation.