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StAR: Text message reminders may help adults lower BP
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Compared with the usual care, an automated adherence support program delivered by text message was associated with a small decrease in systolic BP at 12 months, according to results from the StAR trial.
The effect was not increased by an interactive intervention, researchers found.
“We knew that text messages had worked to support people with HIV/AIDS to stick to their treatment and improve their health as a result. We wanted to see whether the messages could work for [BP] treatment in a deprived community,” Andrew Farmer, DM, from the department of primary health care sciences at Oxford University, said in a press release.
Farmer and colleagues randomly assigned 1,372 adults from South Africa being treated for high BP to receive information-only short message system (SMS) text messages, interactive text messaging or the usual care.
The primary endpoint was change in systolic BP from baseline to 12 months.
At 12 months, compared with the usual care, mean adjusted change in systolic BP was –2.2 mm Hg (95% CI, –4.4 to –0.04) in the group receiving information-only text messages and –1.6 mm Hg (95% CI, –3.7 to 0.6) in the group receiving interactive text messages, Farmer and colleagues wrote.
Compared with the usual-care group, both text messaging groups were more likely to achieve BP less than 140/90 mm Hg during the study period (OR for information-only group = 1.42; 95% CI, 1.03-1.95; OR for interactive group = 1.41; 95% CI, 1.02-1.95), they found.
“The improvements seen were equivalent to those expected from intensive one-to-one behavioral counseling, which is usually more expensive,” Farmer said in the release. “When we consider that those good at sticking to treatment are 20% less likely to die prematurely than those who don’t manage that, any relatively low-cost intervention that helps people manage their high [BP] successfully can save the very real personal, social and economic costs of the disease.”
Niteesh K. Choudhry
In a related editorial, Julie C. Lauffenburger, PharmD, PhD, and Niteesh K. Choudhry, MD, PhD, both from Brigham and Women’s Hospital and Harvard Medical School, wrote that although the clinical effects demonstrated were modest, possibly because the usual-care group received consistent care from a free clinic, “the low cost of SMS texting interventions may still make small reductions in [BP] relatively cost-effective, similar to the clinically modest yet cost-savings effect of mailed educational materials to encourage medication adherence.”
It is also possible that “alternative methods of text messaging could conceivably lead to larger effects,” so further study is necessary, they wrote. – by Erik Swain
Disclosure: The researchers and Lauffenburger report no relevant financial disclosure. Choudhry reports receiving institutional research funding from Medisafe.
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