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JAMA. 2015 Sep 22-29;314(12):1255-63. doi: 10.1001/jama.2015.10945.

Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients With Coronary Heart Disease: A Randomized Clinical Trial.

Author information

1
The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia2Westmead Hospital, Sydney, Australia.
2
The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.
3
The George Institute for Global Health, University of Sydney, Sydney, Australia4Royal Perth Hospital, Perth, Australia5University of Western Australia, Perth.
4
Westmead Hospital, Sydney, Australia3The George Institute for Global Health, University of Sydney, Sydney, Australia.
5
The George Institute for Global Health, University of Sydney, Sydney, Australia.
6
Queensland University of Technology, Queensland, Australia.
7
Westmead Hospital, Sydney, Australia.
8
University of Auckland, Auckland, New Zealand.
9
Westmead Hospital, Sydney, Australia8University of Sydney, Sydney, Australia.

Erratum in

Abstract

IMPORTANCE:

Cardiovascular disease prevention, including lifestyle modification, is important but underutilized. Mobile health strategies could address this gap but lack evidence of therapeutic benefit.

OBJECTIVE:

To examine the effect of a lifestyle-focused semipersonalized support program delivered by mobile phone text message on cardiovascular risk factors.

DESIGN AND SETTING:

The Tobacco, Exercise and Diet Messages (TEXT ME) trial was a parallel-group, single-blind, randomized clinical trial that recruited 710 patients (mean age, 58 [SD, 9.2] years; 82% men; 53% current smokers) with proven coronary heart disease (prior myocardial infarction or proven angiographically) between September 2011 and November 2013 from a large tertiary hospital in Sydney, Australia.

INTERVENTIONS:

Patients in the intervention group (nā€‰=ā€‰352) received 4 text messages per week for 6 months in addition to usual care. Text messages provided advice, motivational reminders, and support to change lifestyle behaviors. Patients in the control group (n=358) received usual care. Messages for each participant were selected from a bank of messages according to baseline characteristics (eg, smoking) and delivered via an automated computerized message management system. The program was not interactive.

MAIN OUTCOMES AND MEASURES:

The primary end point was low-density lipoprotein cholesterol (LDL-C) level at 6 months. Secondary end points included systolic blood pressure, body mass index (BMI), physical activity, and smoking status.

RESULTS:

At 6 months, levels of LDL-C were significantly lower in intervention participants, with concurrent reductions in systolic blood pressure and BMI, significant increases in physical activity, and a significant reduction in smoking. The majority reported the text messages to be useful (91%), easy to understand (97%), and appropriate in frequency (86%). [table: see text].

CONCLUSIONS AND RELEVANCE:

Among patients with coronary heart disease, the use of a lifestyle-focused text messaging service compared with usual care resulted in a modest improvement in LDL-C level and greater improvement in other cardiovascular disease risk factors. The duration of these effects and hence whether they result in improved clinical outcomes remain to be determined.

TRIAL REGISTRATION:

anzctr.org.au Identifier: ACTRN12611000161921.

PMID:
26393848
DOI:
10.1001/jama.2015.10945
[Indexed for MEDLINE]
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