According to a study published in JAMA, a simple, low-cost automated program of semi-personalised mobile phone text messages supporting lifestyle change led to improvement in low-density lipoprotein cholesterol (LDL-C) levels, blood pressure, body mass index, and smoking status in patients with coronary heart disease.
Cardiovascular disease continues to be one of the leading causes of death and disease across the globe. While the use of text messages is rampant, there has been limited scientific evaluation with respect to the use of mobile phone text messages to remind, encourage, and motivate patients to adopt a more healthy lifestyle.
In a study conducted with patients with proven coronary heart disease, Clara K. Chow, MBBS, PhD, of the George Institute for Global Health, University of Sydney, Australia, and colleagues randomly assigned them to receive 4 text messages per week for 6 months in addition to usual care (intervention group; n = 352) or usual care (control group; n=358).
The text messages that were sent to the patients were motivational reminders, supportive and offered advice as to how they could change their lifestyle behaviours. At six months follow-up, patients with intervention through lifestyle focused text messaging demonstrated lower levels of LDL-C, systolic blood pressure and body mass index. There were also less smokers in the intervention group. The proportion of patients achieving 3 of 5 guideline target levels of risk factors were substantially higher in the intervention group vs the control group (63 percent vs. 34 percent).
91 percent of the participants reported that they found the text messages to be useful. 97 percent said the messages were easy to understand while 86 percent said that they were appropriate in frequency.
In an accompanying editorial, Zubin J. Eapen, MD, MHS, and Eric D. Peterson, MD, MPH. of the Duke Clinical Research Institute, Durham, N.C point out that the healthcare systems need to change according to technology and should test and implement novel low-risk interventions such as text messaging in the context of routine clinical care. They say that "creating an agile and clinically integrated research framework that rigorously evaluates all interventions--drug, device, or digital--is a collective responsibility and challenge for both app developers and health care practitioners. Solving this dilemma can enable the development and use of pragmatic, scalable, and evidence-based solutions that can address a massive problem like cardiovascular disease."
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