Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients With Coronary Heart Disease A Randomized Clinical Trial
Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients With Coronary Heart Disease A Randomized Clinical Trial
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DOI：
10.1001/jama.2015.10945
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发表时间：
2015-09-22
影响因子：
120.7
通讯作者：
Thiagalingam, Aravinda
中科院分区：
文献类型：
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作者：
Chow, Clara K.;Redfern, Julie;Thiagalingam, Aravinda
重要性心血管疾病预防（包括改变生活方式）很重要，但未得到充分利用。移动的健康策略可以解决这一差距，但缺乏证据的治疗效益。目的探讨影响的生活方式为重点的半个性化支持计划提供的移动的手机短信对心血管危险因素。设计和设置烟草，运动和饮食信息（TEXT ME）试验是一个平行组，单盲，随机临床试验，招募了710名患者（平均年龄，58 [SD，9.2]岁; 82%男性; 53%目前吸烟者），已证实患有冠心病（既往心肌梗死或经血管造影证实），2011年9月至2013年11月，来自悉尼一家大型三级医院，干预干预组的患者（n = 352）除了常规护理外，每周接受4条短信，持续6个月。短信提供了建议，动机提醒，并支持改变生活方式的行为。对照组358例，给予常规护理。根据基线特征（如吸烟）从一组信息中选择每个参与者的信息，并通过自动计算机化信息管理系统传递。主要结果和措施的主要终点是低密度脂蛋白胆固醇（LDL-C）水平在6个月。次要终点包括收缩压，身体质量指数（BMI），体力活动，和吸烟status.Results在6个月，LDL-C水平显着降低干预参与者，同时降低收缩压和BMI，体力活动显着增加，并显着减少吸烟。大多数人认为短信有用（91%），易于理解（97%），频率合适（86%）。[图表]结论和相关性在冠心病患者中，与常规护理相比，使用以生活方式为重点的短信服务可使LDL-C水平适度改善，并使其他心血管疾病风险因素得到更大改善。这些效应的持续时间以及它们是否会改善临床结局仍有待确定。
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 (n =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%).[GRAPHICS]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.