Chow, Clara K

Klimis, Harry

Thiagalingam, Aravinda

Redfern, Julie

Hillis, Graham S

Brieger, David

Atherton, John

Bhindi, Ravinay

Chew, Derek P

Collins, Nicholas

Andrew Fitzpatrick, Michael

Juergens, Craig

Kangaharan, Nadarajah

Maiorana, Andrew

McGrady, Michele

Poulter, Rohan

Shetty, Pratap

Waites, Jonathon

Hamilton Craig, Christian

Thompson, Peter

Stepien, Sandrine

Von Huben, Amy

Rodgers, Anthony

2022-05-10

BACKGROUND: TEXTMEDS (Text Messages to Improve Medication Adherence and Secondary Prevention After Acute Coronary Syndrome) examined the effects of text message-delivered cardiac education and support on medication adherence after an acute coronary syndrome. METHODS: TEXTMEDS was a single-blind, multicenter, randomized controlled trial of patients after acute coronary syndrome. The control group received usual care (secondary prevention as determined by the treating clinician); the intervention group also received multiple motivational and supportive weekly text messages on medications and healthy lifestyle with the opportunity for 2-way communication (text or telephone). The primary end point of self-reported medication adherence was the percentage of patients who were adherent, defined as >80% adherence to each of up to 5 indicated cardioprotective medications, at both 6 and 12 months. RESULTS: A total of 1424 patients (mean age, 58 years [SD, 11]; 79% male) were randomized from 18 Australian public teaching hospitals. There was no significant difference in the primary end point of self-reported medication adherence between the intervention and control groups (relative risk, 0.93 [95% CI, 0.84-1.03]; P=0.15). There was no difference between intervention and control groups at 12 months in adherence to individual medications (aspirin, 96% vs 96%; β-blocker, 84% vs 84%; angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, 77% vs 80%; statin, 95% vs 95%; second antiplatelet, 84% vs 84% [all P>0.05]), systolic blood pressure (130 vs 129 mm Hg; P=0.26), low-density lipoprotein cholesterol (2.0 vs 1.9 mmol/L; P=0.34), smoking (P=0.59), or exercising regularly (71% vs 68%; P=0.52). There were small differences in lifestyle risk factors in favor of intervention on body mass index <25 kg/m(2) (21% vs 18%; P=0.01), eating ≥5 servings per day of vegetables (9% vs 5%; P=0.03), and eating ≥2 servings per day of fruit (44% vs 39%; P=0.01). CONCLUSIONS: A text message-based program had no effect on medical adherence but small effects on lifestyle risk factors. REGISTRATION: URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364448; Unique identifier: ANZCTR ACTRN12613000793718.

Westmead Applied Research Institute (C.K.C., H.K., A.T., A.V.H., A.R.), University of Sydney, Australia.

Department of Cardiology, Westmead Hospital, Sydney, Australia (C.K.C., H.K., A.T.).

Faculty of Medicine and Health (J.R., R.B., M.A.F., M.M.), University of Sydney, Australia.

University of Western Australia, Perth (G.S.H., P.T.).

Department of Cardiology, Royal Perth Hospital, Australia (G.S.H.).

ANZAC Research Institute (D.B.), University of Sydney, Australia.

Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Australia (J.A.).

The University of Queensland, Brisbane, Australia (J.A., C.H.C.).

Department of Cardiology, Royal North Shore Hospital, Sydney, Australia (R.B.).

College of Medicine and Public Health, Flinders University, Adelaide, South Australia (D.P.C., N.K.).

Hunter Medical Research Institute, Newcastle, Australia (N.C.).

Faculty of Medicine, The University of New South Wales, Sydney, Australia (C.J.).

Department of Cardiology, Liverpool Hospital, Sydney, Australia (C.J.).

Department of Cardiology, Royal Darwin Hospital, Darwin, Australia (N.K.).

Menzies School of Health Research, Darwin, Australia (N.K.).

Allied Health Department, Fiona Stanley Hospital, Perth, Australia (A.M.).

School of Allied Health, Curtin University, Perth, Australia (A.M.).

Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia (M.M.).

Department of Cardiology, Sunshine Coast University Hospital, Brisbane, Australia (R.P.).

Department of Cardiology, Wollongong and Shellharbour Hospitals, Wollongong, Australia (P.S.).

Coffs Cardiology, Coffs Harbour, Australia (J.W.).

Department of Cardiology, Prince Charles Hospital, Brisbane, Australia (C.H.C.).

Department of Cardiology, Sir Charles Gairdner Hospital, Perth, Australia (P.T.).

Harry Perkins Institute of Medical Research, Perth, Australia (P.T.).

The George Institute for Global Health, Sydney, Australia (C.K.C., H.K., A.R., G.S.H., S.S., A.R.).

Circulation. 2022 May 10;145(19):1443-1455. doi: 10.1161/CIRCULATIONAHA.121.056161. Epub 2022 May 9.

0000-0003-4693-0038

0000-0002-3635-421X

0000-0001-8707-5563

0000-0003-2417-4673

0000-0001-6115-0326

0000-0003-3593-296X

0000-0002-0681-1707

0000-0002-6561-7496

0000-0001-6168-9719

https://pubmed.ncbi.nlm.nih.gov/35533220/?otool=iaurydwlib

https://hdl.handle.net/10137/12171

145

*Acute Coronary Syndrome/drug therapy/prevention & control

Australia

Female

Humans

Male

Medication Adherence

Middle Aged

Secondary Prevention

Single-Blind Method

*Text Messaging

Text Messages to Improve Medication Adherence and Secondary Prevention After Acute Coronary Syndrome: The TEXTMEDS Randomized Clinical Trial.

Journal Article

Publication