The Impact of Text Messaging on Medication Adherence and Exercise Regimen Among Post-myocardial Infarction Patients

Study Overview
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Brief Summary
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The purpose of this study is to assess the impact of text message reminders on adherence to medications and exercise in patients recently discharged from the hospital after a myocardial infarction (MI).

Detailed Description
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The Impact of Text Messaging on Medication Adherence and Exercise Regimen among Post-Myocardial Infarction Patients includes two single-center randomized control trials to assess the impact of text message reminds on adherence to medications and exercise regimen in patients recently discharged from the hospital after MI. Recruitment conducted at Cambridge Cardiac Rehabilitation in Ontario, Canada for both the medication adherence and exercise trial. Potential study subjects are evaluated for inclusion and exclusion criteria, give written informed consent, and are randomized, in a 1:1 ratio, to either intervention or usual care (control). Patients randomized to the intervention arm in the medication adherence trial receive an automated text message once per day at the time they are prescribed to take their medication. The text message does not contain any personal or pharmacological information. Patients randomized to the intervention arm in the exercise adherence trial receive four text messages per day at 7:30 am, 12:00 pm, 6:00 pm, and 9:00 pm, reminding them to exercise for 30 minutes per day as per their health care provider.

Official Title
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The Impact of Text Messaging on Medication Adherence and Exercise Regimen Among Post-myocardial Infarction Patients

Conditions
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Myocardial Infarction

Intervention / Treatment
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* Behavioral: Text message reminder for medication adherence
* Behavioral: Text message reminder for exercise regimen


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Post-MI hospital discharge within 2 weeks Enrolled in cardiac rehabilitation Prescribed anti-platelets, beta-blockers, ACE-inhibitors or ARBs, and/or statins on 1x/day regimen (for medication adherence trial) Prescribed exercise regimen (for exercise trial) Ability to read and write English Possession of a cell phone with text messaging capability Exclusion Criteria: Age < 18 Incarcerated individuals Unable to read and write English Not in possession of a cell phone Patients prescribed medication regimen > 1x/day

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Medication text message<br>Once daily text message reminder. | Behavioral: Text message reminder for medication adherence<br>* Patients randomized to this arm receive one text message per day (at the scheduled time) reminding them to take their medication.<br>|
| Experimental: Exercise text message<br>4x daily text message reminder. | Behavioral: Text message reminder for exercise regimen<br>* Patients randomized to this arm receive 4 daily text messages reminding them to exercise for 30 minutes per day.<br>|
| No Intervention: Usual care, medication adherence<br>Usual care for medication adherence. | |
| No Intervention: Usual care, exercise regimen<br>Usual care for exercise regimen. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medication adherence | Average medication adherence over 12 months after randomization, assessed with self-reported logs | 12 months | 
| Exercise frequency | Average frequency of exercise over 12 months after randomization, assessed with self-reported logs | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Exercise duration | Average duration of exercise assessed by BRUCE protocol | 12 months | 
| Full medication adherence | Average medication adherence over 12 months greater than .80 | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exercise adherence, Medication adherence, Mobile health, Cardiac rehabilitation