A simple text message can help lower blood pressure and body mass index (BMI) in those with heart disease, according to new research recently published in the journal Open Heart.
The systematic review – conducted by researchers at Deakin University and the University of Sydney – crunched the numbers on nine different evaluations of text message interventions around the world involving 3779 participants, testing their impact on the two key measures of disease risk, blood pressure and BMI.
One of the studies in the review also modelled the cost-effectiveness of implementing a text-message intervention to 50,000 patients with coronary heart disease, showing it could lead to 563 fewer heart attacks, 361 fewer strokes, and an overall saving to the health system of $10.56 million over the lifetime of these patients.
Lead researcher and former cardiologist Dr Shariful Islam – a National Heart Foundation Senior Research Fellow in Deakin's Institute for Physical Activity and Nutrition (IPAN) – said when you considered nearly 600,000 Australians alive today would have heart disease at some point, the potential impact was huge.
"Text messaging interventions offer good value for money to reduce heart disease risk as they're effective, cheap and could be implemented at scale," Dr Islam said.
"While the 0.2 reduction in BMI and a 1.3 mm reduction in blood pressure we found in our review may not sound like a lot, this adds up to quite a large impact when you scale it up across the Australian population.
"Heart disease is the number one killer in Australia and around the world, and deaths due to cardiovascular disease have steadily increased globally over the last four decades.
"Common and modifiable risk factors, including high blood pressure, smoking, high cholesterol, obesity and physical inactivity, contribute substantially to the risk of cardiovascular disease and premature death.
"Yet identifying low-cost, scalable and effective strategies to target all of these to prevent cardiovascular disease remains a major challenge. It's also important to identify interventions that can reduce multiple risk factors at the same time."
Dr Islam said the text message interventions worked by promoting behaviour change, including techniques like increasing motivation, goal-setting and medication reminders.
"As a clinician there's often not time to give extensive advice about things like diet and physical activity, as they may have less than 15 minutes with their patients," he said.
"Text messaging can provide additional support that a person might need. It's not an alternative but a value-add, which can be especially beneficial in areas where people have less access to face-to-face support."
The regular text messages provide motivation and advice on how to improve lifestyle behaviours to help lower the risk of heart disease – including physical activity and a healthy diet.
Co-authors and leads of the original TEXT ME study Professor Clara Chow and Professor Julie Redfern, from the University of Sydney's Westmead Applied Research Centre, are leading a number of trials for text message intervention including medication adherence.
"Our aim is to implement these programs to support health systems nationally," Professor Redfern said.
Professor Chow said in the studies evaluated as part of the research most participants reported moderate to high levels of satisfaction with the text message programs.
"That means we know patients find this regular support helpful and motivating," she said.
"Behaviour change is an important component in reducing disease risk over time, and BMI and blood pressure are the best indicators to show that reduction. Just a 5mm reduction in blood pressure can reduce your chance of a heart attack."
Dr Islam is currently undertaking further research exploring the use of text messaging to influence behaviour change to reduce heart disease risk.