Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis

Sheikh Mohammed Shariful Islam; Andrew J. Farmer; Kirsten Bobrow; Ralph Maddison; Robyn Whittaker; Leila Anne Pfaeffli Dale; Andreas Lechner; Scott Lear; Zubin Eapen; Louis Niessen; Karla Santo; Sandrine Stepien; Julie Redfern; Anthony Rodgers; Clara K. Chow

doi:10.1136/openhrt-2019-001017

Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis

Sheikh Mohammed Shariful Islam, Andrew J. Farmer, Kirsten Bobrow, Ralph Maddison, Robyn Whittaker, Leila Anne Pfaeffli Dale, Andreas Lechner, Scott Lear, Zubin Eapen, Louis Niessen, Karla Santo, Sandrine Stepien, Julie Redfern, Anthony Rodgers, Clara K. Chow

International Public Health

Research output: Contribution to journal › Review article › peer-review

60 Citations (Scopus)

Abstract

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 metaanalysis 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.

Original language	English
Article number	e001017
Pages (from-to)	e001017
Journal	Open Heart
Volume	6
Issue number	2
DOIs	https://doi.org/10.1136/openhrt-2019-001017
Publication status	Published - 9 Oct 2019

Keywords

cardiovascular diseases
cardiovascular risk factors
diabetes
mHealth
mobile phones
short message service

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/openhrt-2019-001017Licence: CC BY-NC

Open Heart J Meta-analysis Mobile messagesFinal published version, 605 KBLicence: CC BY-NC

Cite this

Shariful Islam, S. M., Farmer, A. J., Bobrow, K., Maddison, R., Whittaker, R., Pfaeffli Dale, L. A., Lechner, A., Lear, S., Eapen, Z., Niessen, L., Santo, K., Stepien, S., Redfern, J., Rodgers, A., & Chow, C. K. (2019). Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis. Open Heart, 6(2), e001017. Article e001017. https://doi.org/10.1136/openhrt-2019-001017

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title = "Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis",

abstract = "Background A variety of small mobile phone text messaginginterventions 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-messaginginterventions 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 usedrandom-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 metaanalysis 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 riskfactors occurs.",

keywords = "cardiovascular diseases, cardiovascular risk factors, diabetes, mHealth, mobile phones, short message service",

author = "\{Shariful Islam\}, \{Sheikh Mohammed\} and Farmer, \{Andrew J.\} and Kirsten Bobrow and Ralph Maddison and Robyn Whittaker and \{Pfaeffli Dale\}, \{Leila Anne\} and Andreas Lechner and Scott Lear and Zubin Eapen and Louis Niessen and Karla Santo and Sandrine Stepien and Julie Redfern and Anthony Rodgers and Chow, \{Clara K.\}",

year = "2019",

month = oct,

day = "9",

doi = "10.1136/openhrt-2019-001017",

language = "English",

volume = "6",

pages = "e001017",

journal = "Open Heart",

issn = "2053-3624",

publisher = "BMJ Publishing Group",

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Shariful Islam, SM, Farmer, AJ, Bobrow, K, Maddison, R, Whittaker, R, Pfaeffli Dale, LA, Lechner, A, Lear, S, Eapen, Z, Niessen, L, Santo, K, Stepien, S, Redfern, J, Rodgers, A & Chow, CK 2019, 'Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis', Open Heart, vol. 6, no. 2, e001017, pp. e001017. https://doi.org/10.1136/openhrt-2019-001017

Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis. / Shariful Islam, Sheikh Mohammed; Farmer, Andrew J.; Bobrow, Kirsten et al.
In: Open Heart, Vol. 6, No. 2, e001017, 09.10.2019, p. e001017.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis

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

AU - Santo, Karla

AU - Stepien, Sandrine

AU - Redfern, Julie

AU - Rodgers, Anthony

AU - Chow, Clara K.

PY - 2019/10/9

Y1 - 2019/10/9

N2 - Background A variety of small mobile phone text messaginginterventions 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-messaginginterventions 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 usedrandom-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 metaanalysis 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 riskfactors occurs.

AB - Background A variety of small mobile phone text messaginginterventions 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-messaginginterventions 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 usedrandom-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 metaanalysis 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 riskfactors occurs.

KW - cardiovascular diseases

KW - cardiovascular risk factors

KW - diabetes

KW - mHealth

KW - mobile phones

KW - short message service

U2 - 10.1136/openhrt-2019-001017

DO - 10.1136/openhrt-2019-001017

M3 - Review article

SN - 2053-3624

VL - 6

SP - e001017

JO - Open Heart

JF - Open Heart

IS - 2

M1 - e001017

ER -

Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis

Abstract

Keywords

UN SDGs

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