TY - JOUR
T1 - Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD)
T2 - Systematic review and individual patient data meta-analysis
AU - Text2PreventCVD Collaboration
AU - Shariful Islam, Sheikh Mohammed
AU - Farmer, Andrew J.
AU - Bobrow, Kirsten
AU - Maddison, Ralph
AU - Whittaker, Robyn
AU - Pfaeffli Dale, Leila Anne
AU - Lechner, Andreas
AU - Lear, Scott
AU - Eapen, Zubin
AU - Niessen, Louis Wilhelmus
AU - Santo, Karla
AU - Stepien, Sandrine
AU - Redfern, Julie
AU - Rodgers, Anthony
AU - Chow, Clara K.
N1 - Funding Information:
SMSI was funded by a senior research fellowship from the Institute for Physical Activity and Nutrition, Deakin University, and was a recipient of The George Institute for Global Health postdoctorate fellowship and early career transition grant from the High Blood Pressure Research Council of Australia. AF is a National Institute for Health Research (NIHR) senior investigator and received support from NIHR Oxford Biomedical Research Centre. JR was funded by a Career Development and Future Leader Fellowship cofunded by the National Health and Medical Research Council and the National Heart Foundation (APP1061793). AR has a NHMRC Principal Fellowship. CKC is funded by Career Development Fellowship cofunded by the National Health and Medical Research Council and the National Heart Foundation and the Sydney Medical Foundation Chapman Fellowship (1033478). KS is funded by a University of Sydney International Postgraduate Research Scholarship.
Funding Information:
Funding SMSI was funded by a senior research fellowship from the Institute for Physical Activity and Nutrition, Deakin University, and was a recipient of The George Institute for Global Health postdoctorate fellowship and early career transition grant from the High Blood Pressure Research Council of Australia. AF is a National Institute for Health Research (NIHR) senior investigator and received support from NIHR Oxford Biomedical Research Centre. JR was funded by a Career Development and Future Leader Fellowship cofunded by the National Health and Medical Research Council and the National Heart Foundation (APP1061793). AR has a NHMRC Principal Fellowship. CKC is funded by Career Development Fellowship cofunded by the National Health and Medical Research Council and the National Heart Foundation and the Sydney Medical Foundation Chapman Fellowship (1033478). KS is funded by a University of Sydney International Postgraduate Research Scholarship. Competing interests None declared. Patient consent for publication Not required.
Publisher Copyright:
© 2019 Author(s).
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Background: A variety of small mobile phone text-messaging interventions have indicated improvement in risk factors for cardiovascular disease (CVD). Yet the extent of this improvement and whether it impacts multiple risk factors together is uncertain. We aimed to conduct a systematic review and individual patient data (IPD) meta-analysis to investigate the effects of text-messaging interventions for CVD prevention. Methods: Electronic databases were searched to identify trials investigating a text-messaging intervention focusing on CVD prevention with the potential to modify at least two CVD risk factors in adults. The main outcome was blood pressure (BP). We conducted standard and IPD meta-analysis on pooled data. We accounted for clustering of patients within studies and the primary analysis used random-effects models. Sensitivity and subgroup analyses were performed. Results: Nine trials were included in the systematic review involving 3779 participants and 5 (n=2612) contributed data to the IPD meta-analysis. Standard meta-analysis showed that the weighted mean differences are as follows: systolic blood pressure (SBP), -4.13 mm Hg (95% CI -11.07 to 2.81, p<0.0001); diastolic blood pressure (DBP), -1.11 mm Hg (-1.91 to -0.31, p=0.002); and body mass index (BMI), -0.32 (-0.49 to -0.16, p=0.000). In the IPD meta-analysis, the mean difference are as follows: SBP, -1.3 mm Hg (-5.4 to 2.7, p=0.5236); DBP, -0.8 mm Hg (-2.5 to 1.0, p=0.3912); and BMI, -0.2 (-0.8 to 0.4, p=0.5200) in the random-effects model. The impact on other risk factors is described, but there were insufficient data to conduct meta-analyses. Conclusion: Mobile phone text-messaging interventions have modest impacts on BP and BMI. Simultaneous but small impacts on multiple risk factors are likely to be clinically relevant and improve outcome, but there are currently insufficient data in pooled analyses to examine the extent to which simultaneous reduction in multiple risk factors occurs.
AB - Background: A variety of small mobile phone text-messaging interventions have indicated improvement in risk factors for cardiovascular disease (CVD). Yet the extent of this improvement and whether it impacts multiple risk factors together is uncertain. We aimed to conduct a systematic review and individual patient data (IPD) meta-analysis to investigate the effects of text-messaging interventions for CVD prevention. Methods: Electronic databases were searched to identify trials investigating a text-messaging intervention focusing on CVD prevention with the potential to modify at least two CVD risk factors in adults. The main outcome was blood pressure (BP). We conducted standard and IPD meta-analysis on pooled data. We accounted for clustering of patients within studies and the primary analysis used random-effects models. Sensitivity and subgroup analyses were performed. Results: Nine trials were included in the systematic review involving 3779 participants and 5 (n=2612) contributed data to the IPD meta-analysis. Standard meta-analysis showed that the weighted mean differences are as follows: systolic blood pressure (SBP), -4.13 mm Hg (95% CI -11.07 to 2.81, p<0.0001); diastolic blood pressure (DBP), -1.11 mm Hg (-1.91 to -0.31, p=0.002); and body mass index (BMI), -0.32 (-0.49 to -0.16, p=0.000). In the IPD meta-analysis, the mean difference are as follows: SBP, -1.3 mm Hg (-5.4 to 2.7, p=0.5236); DBP, -0.8 mm Hg (-2.5 to 1.0, p=0.3912); and BMI, -0.2 (-0.8 to 0.4, p=0.5200) in the random-effects model. The impact on other risk factors is described, but there were insufficient data to conduct meta-analyses. Conclusion: Mobile phone text-messaging interventions have modest impacts on BP and BMI. Simultaneous but small impacts on multiple risk factors are likely to be clinically relevant and improve outcome, but there are currently insufficient data in pooled analyses to examine the extent to which simultaneous reduction in multiple risk factors occurs.
KW - cardiovascular diseases
KW - cardiovascular risk factors
KW - diabetes
KW - mHealth
KW - mobile phones
KW - short message service
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U2 - 10.1136/openhrt-2019-001017
DO - 10.1136/openhrt-2019-001017
M3 - Review article
C2 - 31673381
AN - SCOPUS:85073237325
SN - 2398-595X
VL - 6
JO - Open Heart
JF - Open Heart
IS - 2
M1 - e001017
ER -