Coronary heart disease (CHD) is a disease in which plaque, a waxy substance, builds up in the coronary arteries. There are various treatments that have been shown to reduce the risk of major events adverse events associated with CHD however research suggests that these often have low uptake and are not well adhered to.

These include medication and uptake of positive lifestyle behaviours. There are various potential reasons for minimal engagement with behaviours that reduce risk of adverse CHD events including geographical barriers and lack of time. Mobile health, the use of mobile phone technology in healthcare, is being increasingly implemented to deliver and support healthcare initiatives.

It is a popular tool given the number of people worldwide with a mobile phone and the ability of mobile health to break down the barriers of geography, time and access. Mobile health could be an effective solution to encourage uptake of healthy behaviours particular in high risk groups such as people with CHD.

Researchers evaluated the effectiveness of a text message-based intervention to encourage lifestyle change on heart risk factors in people with CHD.

Adults with CHD were recruited to participate in the Tobacco, Exercise and Diet Messages (TEXT ME) study. They were randomised to either the intervention or control group. People in the intervention group received four semi-personalised text messages each week for 24 weeks.

The messages provided advice, motivation and information that aimed to improve people’s diet, increase levels of physical activity and encourage smoking cessation in those who smoked. People in the control group received usual care, which typically involved follow up with those who had been referred to inpatient cardiac rehabilitation centres by their usual physician.

Outcomes assessed included level of LDL cholesterol (LDL-C) in the blood, systolic blood pressure, body mass index (BMI), waist circumference, total physical activity levels and smoking status. These were measured at baseline and after six months.

The results showed a significant reduction in LDL-C levels, systolic blood pressure and BMI in the intervention group at six months compared to the control group.

People who received the intervention were more likely to control their blood pressure, exercise more frequently and quit smoking than those in the control group. Furthermore, a higher proportion of intervention group participants achieved the target levels for four or more key risk factors.

Implications

This study adds to the growing body of evidence assessing the effectiveness of mobile health technology to bring about positive behaviour change.

For people with CHD, a text message intervention resulted in more positive lifestyle modifications and reduction in risk factors associated with adverse heart events.

Given the high prevalence of cardiovascular disease in Australia, a low cost intervention such as this might be a powerful tool to break down the barriers created by access, geography and time and encourage people to make meaning changes to their behaviour to bring about better heart outcomes.

Last Reviewed: 10/11/2019

© Norman Swan Medical Communications.



References

Chow, C. et al. (2015). Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients with Coronary Heart Disease. JAMA, 314, 1255 – 1263. doi: 10.1001/jama.2015.10945.