Motivational Texting for Heart Attack Care

Overseen By Sulagna Sarker

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Sunnybrook Health Sciences Centre

Disqualifiers: Inability to consent, others

Compensation: Varies

Number of Visits: Unknown

Duration: 12 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether motivational text messages can improve care and recovery for heart attack patients. Researchers aim to determine if these texts can reduce complications and hospital readmissions by delivering support and health information directly to patients' phones. The trial includes two groups: one receiving general texts and the other receiving health-specific messages. Ideal participants are those treated for a heart attack at Sunnybrook Hospital who have a cellphone capable of receiving texts. As an unphased trial, this study allows participants to contribute to innovative research that could enhance heart attack recovery for future patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that motivational texting is safe for heart attack patients?

Research has shown that motivational texting is generally safe and well-received by participants. One study used a 60-day text messaging program to help patients manage their care after a heart-related event. This study focused on self-care and did not find any major safety issues.

Other studies have also found that texting programs can positively impact heart health. These programs primarily aim to improve health habits rather than directly treat medical conditions, suggesting a low risk of negative effects.

Overall, motivational texting is a non-invasive method designed to support and guide patients without the risks associated with medications or surgeries. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the motivational texting intervention for heart attack care because it offers a personalized approach to patient support that differs from traditional methods like medication or in-person counseling. Unlike standard treatments that often rely on regular doctor visits or lifestyle changes, this innovative method uses targeted health-related text messages to encourage and motivate patients in their recovery process. By utilizing the widespread accessibility of mobile phones, this approach has the potential to reach patients more frequently and conveniently, fostering better adherence to care plans and potentially improving recovery outcomes.

What evidence suggests that this trial's treatments could be effective for heart attack care?

Research shows that texting can significantly benefit heart health. In this trial, participants in the texting intervention group will receive specific health-related texts. Studies have found that such texts help people manage heart disease risk factors more effectively. For example, texts can remind patients to take their medication or encourage them to stay active, reducing hospital visits. One study found that texting improved both mental health and physical activity in heart patients. Another report suggested that mobile health tools, like texting, could lower the chances of major heart problems and hospital visits. Overall, motivational texting appears to be a promising method for aiding heart attack recovery and prevention. ^{5 6 7 8 9}

Who Is on the Research Team?

Dennis Ko, MD

Principal Investigator

Research Director

Are You a Good Fit for This Trial?

This trial is for heart attack patients over 18 who were treated at Sunnybrook Hospital, have a cellphone with texting, and can read and respond to English texts. It's not for those who can't consent in English or lack SMS-capable phones.

Inclusion Criteria

I was admitted to Sunnybrook Hospital with a heart attack or related condition.

I am older than 18 years.

Access to a cellphone that can receive text messages

Exclusion Criteria

I cannot give consent in English.

You don't have a cellphone that can send and receive text messages.

Inability to read or answer English texts

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive mobile text message-based interventions to improve care transitions after hospitalization with heart attack

12 months

Ongoing virtual interactions via text messages

Follow-up

Participants are monitored for medication compliance, re-hospitalization, and emergency department presentations

12 months

Data collection through existing registries and databases

What Are the Treatments Tested in This Trial?

Interventions

• Control
• Motivational texting
• Texting intervention

Trial Overview The TEACH pilot trial tests if motivational text messages after hospital discharge can improve care for heart attack patients. Participants are randomly assigned to receive these texts or be in a control group without them.

How Is the Trial Designed?

Group I: Texting intervention group Experimental Treatment 1 Intervention

Subjects will receive specific health-related texts

Group II: Control group Placebo Group 1 Intervention

Subjects will receive general text messages without health information

Who Is Running the Clinical Trial?

Sunnybrook Health Sciences Centre

Lead Sponsor

Trials

693

Recruited

1,569,000+

Published Research Related to This Trial

This study aims to evaluate the effectiveness of different reminder methods (text messages, reminder calls, or both) in increasing the use of service referrals among 300 participants from community outreach programs.

The research will help determine how mobile phone-based interventions can enhance community engagement and service utilization, potentially guiding future reminder protocols for similar programs across the country.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Research Protocol to Test the Effectiveness of Text Messaging and Reminder Calls to Increase Service Use Referrals in a Community Engagement Program. Varma, DS., Hart, M., McIntyre, DS., et al.[2020]

Mobile healthcare technologies, specifically SMS interventions, can enhance communication between healthcare providers and patients, potentially improving post-operative care for abdominal surgical patients.

Implementing SMS for timely self-reported assessments may help prevent complications and reduce the risk of hospital readmissions, addressing the challenges faced by nurses in providing adequate pre- and post-operative instructions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

TextWithSurgeryPatients - A Research Hypothesis in Enhancing Education and Physical Assessment for Abdominal Surgical Patients. Hansen, M.[2018]

A systematic review and meta-analysis of six randomized controlled trials involving 1,158 patients found that text message interventions had no significant effect on self-management outcomes for coronary heart disease, including self-efficacy and various health metrics like LDL and BMI.

The study concluded that using text messages as a method to improve treatment adherence and control risk factors in coronary heart disease patients does not provide any positive benefits compared to usual care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Text Message On Self-Management for Coronary Heart Disease: A Meta-Analysis of Randomized Controlled Trials. Wan, Y., Wu, X., Kou, Y.[2020]

A systematic review of nine trials involving 3779 participants found that mobile phone text-messaging interventions can lead to modest reductions in blood pressure and body mass index, indicating potential benefits for cardiovascular disease prevention.

While the standard meta-analysis showed significant improvements in systolic and diastolic blood pressure and BMI, the individual patient data meta-analysis did not find statistically significant changes, suggesting that while there are benefits, they may be smaller than initially thought.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis. Shariful Islam, SM., Farmer, AJ., Bobrow, K., et al.[2021]

A systematic review of studies from 2002-2016 found that 79% of the 28 studies showed that mobile health interventions, like text messaging and apps, effectively improve cardiovascular disease (CVD) outcomes.

Personalized messages, higher engagement through two-way communication, and using multiple methods were key factors in the success of these interventions, with text messaging proving to be more effective than smartphone apps.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease. Park, LG., Beatty, A., Stafford, Z., et al.[2022]

A systematic review of 12 studies involving text messaging interventions for behavior change found that 8 out of 9 sufficiently powered studies supported its effectiveness in promoting health behavior changes over periods ranging from 3 to 12 months.

The review highlighted the need for more research in developing countries, as most studies were conducted in developed nations, despite the potential for text messaging to be a low-cost health intervention globally.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Text messaging as a tool for behavior change in disease prevention and management. Cole-Lewis, H., Kershaw, T.[2022]

Text messaging interventions for health behaviors showed good acceptance and early efficacy, with 10 out of 16 randomized controlled trials reporting significant improvements in areas like medication adherence and behavior modification.

Despite promising results, the overall evidence is limited by methodological issues, indicating that more rigorous studies are needed to draw definitive conclusions about the effectiveness of text messaging in health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A review of the use of mobile phone text messaging in clinical and healthy behaviour interventions. Wei, J., Hollin, I., Kachnowski, S.[2022]

In a study involving 229 patients with Type 2 diabetes and coronary heart disease, a 6-month lifestyle-focused text messaging intervention significantly reduced systolic blood pressure by an average of 7.6 mmHg and diastolic blood pressure by 3.7 mmHg compared to usual care.

The text messaging intervention also led to a significant reduction in body mass index (BMI) by 0.89 kg/m² and waist circumference by 3.98 cm, demonstrating its effectiveness in managing cardiovascular risk factors in patients with T2DM.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of lifestyle focused text messaging on risk factor modification in patients with diabetes and coronary heart disease: A sub-analysis of the TEXT ME study. Haider, R., Hyun, K., Cheung, NW., et al.[2019]

A machine learning program was developed to triage SMS text message replies in health interventions, achieving high accuracy (AUC 0.86) in identifying which messages required staff review, potentially reducing the workload for health professionals.

Implementing this ML program could enhance the cost-effectiveness and scalability of SMS-based health interventions by decreasing the number of messages needing manual review, thus allowing for broader reach without significantly increasing staffing costs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of a Machine Learning Program to Correctly Triage Incoming Text Messaging Replies From a Cardiovascular Text-Based Secondary Prevention Program: Feasibility Study. Lowres, N., Duckworth, A., Redfern, J., et al.[2021]

A study involving 879 patients with coronary heart disease showed that a 1-way SMS text messaging program significantly improved lifestyle factors such as physical activity, healthy diet, and medication adherence over 6 months, helping patients manage their cardiovascular disease risk.

While the SMS intervention did not lead to significant changes in physiological measures like LDL cholesterol, systolic blood pressure, or BMI, it was well-received by participants, indicating its potential as an affordable tool for lifestyle modification in preventing cardiovascular disease recurrence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

mHealth Interventions for Lifestyle and Risk Factor Modification in Coronary Heart Disease: Randomized Controlled Trial. Bae, JW., Woo, SI., Lee, J., et al.[2021]

The study developed 200 motivational text messages in English and Spanish aimed at encouraging physical activity among low-income, minority patients with diabetes and depression, using an iterative design process that incorporated participant feedback and expert review.

The final selection included 54 messages that were well-received and categorized effectively, demonstrating the importance of user-centered design in creating health interventions tailored to diverse populations with low health literacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing Messaging Content for a Physical Activity Smartphone App Tailored to Low-Income Patients: User-Centered Design and Crowdsourcing Approach. Pathak, LE., Aguilera, A., Williams, JJ., et al.[2021]

Citations

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Digital Health Intervention in Acute Myocardial Infarction - PMC Digital health has been shown to improve secondary prevention for cardiovascular disease in stable outpatient settings, but there has been limited evaluation ...

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Effect of Text Messaging on Risk Factor Management in ... This study demonstrates that a texting messaging intervention to support cardiovascular disease prevention goals was feasible across diverse ...

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Use of text messages to increase positive affect and ... Text messaging focused on well-being and physical activity was well-accepted and associated with improvements in activity and mental health in this high-risk ...

4. jamanetwork.com jamanetwork.com/journals/jama/fullarticle/2442937

Effect of Lifestyle-Focused Text Messaging on Risk Factor ... Our findings are consistent with the existing evidence to support the effectiveness of mobile phone text messaging in changing individual health behaviors.

5. sciencedirect.com sciencedirect.com/science/article/pii/S2352013224000292

Effectiveness of mobile health applications on clinical ... Mobile health apps have the potential to lower the incidence of major adverse cardiac events (MACEs), readmission rates, and blood lipids in patients with CHD.

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An adaptive text message intervention to promote well ... A four-week TMI, which delivers daily messages to promote well-being and adherence to health behaviors and dynamically adapts based on participant feedback.

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Mobile-phone text messaging to promote ideal ... The primary outcome was the difference in the proportion of women with ideal CVH between SMS and control groups at 9 months. Rates of ...

8. ahajournals.org ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056161

The TEXTMEDS Randomized Clinical Trial | Circulation TEXT ME and several other texting intervention trials have demonstrated small but positive effects on objective measures of cardiovascular risk ...

9. mhealth.jmir.org mhealth.jmir.org/2021/5/e24530

The Use of SMS Text Messaging to Improve the Hospital-to ... This study pilot tested a 60-day SMS text messaging intervention (Txt2Prevent) for patients with ACS. The primary objective was to compare self-management ...