While the results of this systematic review are promising , there is insufficient evidence to draw conclusions on the effectiveness of text message-based interventions for adherence to medications for secondary prevention of CVD .
BACKGROUND Worldwide at least 100 million people are thought to have prevalent cardiovascular disease ( CVD ) .
This population has a five times greater chance of suffering a recurrent cardiovascular event than people without known CVD .
Secondary CVD prevention is defined as action aim ed to reduce the probability of recurrence of such events .
Drug interventions have been shown to be cost-effective in reducing this risk and are recommended in international guidelines .
However , adherence to recommended treatments remains sub-optimal .
In order to influence non-adherence , there is a need to develop scalable and cost-effective behaviour-change interventions .
OBJECTIVES To assess the effects of mobile phone text messaging in patients with established arterial occlusive events on adherence to treatment , fatal and non-fatal cardiovascular events , and adverse effects .
Mobile Phone Text Messages to Support Treatment Adherence in Adults With High Blood Pressure (SMS-Text Adherence Support [StAR]): A Single-Blind, Randomized Trial
Background — We assessed the effect of automated treatment adherence support delivered via mobile phone short message system ( SMS ) text messages on blood pressure . Methods and Results — In this pragmatic , single-blind , 3-arm , r and omized trial ( SMS-Text Adherence Support [ StAR ] ) undertaken in South Africa , patients treated for high blood pressure were r and omly allocated in a 1:1:1 ratio to information only , interactive SMS text messaging , or usual care . The primary outcome was change in systolic blood pressure at 12 months from baseline measured with a vali date d oscillometric device . All trial staff were masked to treatment allocation . Analyses were intention to treat . Between June 26 , 2012 , and November 23 , 2012 , 1372 participants were r and omized to receive information-only SMS text messages ( n=457 ) , interactive SMS text messages ( n=458 ) , or usual care ( n=457 ) . Primary outcome data were available for 1256 participants ( 92 % ) . At 12 months , the mean adjusted change in systolic blood pressure compared with usual care was −2.2 mm Hg ( 95 % confidence interval , −4.4 to −0.04 ) with information-only SMS and −1.6 mm Hg ( 95 % confidence interval , −3.7 to 0.6 ) with interactive SMS . Odds ratios for the proportion of participants with a blood pressure < 140/90 mm Hg were 1.42 ( 95 % confidence interval , 1.03–1.95 ) for information-only messaging and 1.41 ( 95 % confidence interval , 1.02–1.95 ) for interactive messaging compared with usual care . Conclusions — In this r and omized trial of an automated adherence support program delivered by SMS text message in a general outpatient population of adults with high blood pressure , we found a small reduction in systolic blood pressure control compared with usual care at 12 months . There was no evidence that an interactive intervention increased this effect . Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT02019823 . South African National Clinical Trials Register , number SANCTR DOH-27 - 1212 - 386 ; Pan Africa Trial Register , number PACTR201411000724141
While the results of this systematic review are promising , there is insufficient evidence to draw conclusions on the effectiveness of text message-based interventions for adherence to medications for secondary prevention of CVD .
BACKGROUND Worldwide at least 100 million people are thought to have prevalent cardiovascular disease ( CVD ) .
This population has a five times greater chance of suffering a recurrent cardiovascular event than people without known CVD .
Secondary CVD prevention is defined as action aim ed to reduce the probability of recurrence of such events .
Drug interventions have been shown to be cost-effective in reducing this risk and are recommended in international guidelines .
However , adherence to recommended treatments remains sub-optimal .
In order to influence non-adherence , there is a need to develop scalable and cost-effective behaviour-change interventions .
OBJECTIVES To assess the effects of mobile phone text messaging in patients with established arterial occlusive events on adherence to treatment , fatal and non-fatal cardiovascular events , and adverse effects .