The Use of Texting Messaging to Improve the Hospital-to-community Transition Period in Cardiovascular Disease Patients (Txt2Prevent)

April 24, 2017 updated by: Scott Lear, Simon Fraser University

The Use of Text Messaging to Improve the Hospital-community Transition and Prevent Readmission in Patients With Cardiovascular Disease (Txt2Prevent)

Participants will be recruited during their hospitalization for either heart attack or unstable angina and will be randomly assigned to either a text message program (Txt2Prevent) or usual care. They will be texted for the first 60-days after discharge. Texts will include topics regarding self-management and discharge protocols such as reminders to make an appointment with their general practitioner or to refill medication prescriptions. After 60 days, the two groups will be compared for hospital readmission rates, quality of life, medication adherence, and self-management.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Cardiovascular disease is one of the leading causes for hospitalization and death in Canada. Being discharged is often a challenging and overwhelming time. Sometimes patients are readmitted to the hospital shortly in the months following their discharge. Some of these readmissions are due to information transfer being poor or insufficient.

Previous studies have looked at whether text messaging can be a simple, cost-effective way to help patients. Therefore, we wish to investigate the effectiveness of using text messaging to help heart patients after they are discharged from the hospital.

The goal of this study is to determine the impact of a pilot text-messaging intervention program (Txt2Prevent) that supports coronary syndrome (heart attack and unstable angina) patients for 60 days after their hospital discharge. The program will include information about follow-up care, medication use, and healthy lifestyle behaviours. The texts will be sent at relevant times during the patients' recovery.

The primary objective is compare self-management between the usual care patients versus the Txt2prevent patients. We hypothesize that the Txt2Prevent group will have better self-management than the usual care group.

The secondary objective is compare medication adherence, and health-related quality of life as well as readmission and mortality rates between the two patient groups. We hypothesize that the Txt2Prevent group will have better outcomes for these variables.

The study population is acute coronary syndrome patients at St. Paul's hospital who are discharged. Participants will be randomly assigned to one of two groups-a usual care group and the usual care plus the Txt2Prevent text messaging program group. All participants will undergo a baseline assessment that includes:

  • Demographics, medical history, medication use and technology use information
  • Self-management skills
  • Health-related quality of life

After 60 days, participants will be contacted again to perform a follow up assessment that includes:

  • Information on readmission, medication use, the use of health services such as cardiac rehab
  • Self-management skills
  • Health-related quality of life
  • Medication adherence

In both the baseline and follow-up assessments, information may be obtained from the patient's medical chart or records (e.g. medical history) or self-report.

After the intervention, some intervention participants will be contacted to complete a semi-structured interview about their experiences with the Txt2Prevent program.

Study Type

Interventional

Enrollment (Actual)

76

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Canada
    • British Columbia
      • Vancouver, British Columbia, Canada, V6Z 1Y6
        • St. Paul's Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

19 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • are an acute coronary syndrome patient on the non-surgical ward who will be discharged home
  • own a phone with text-messaging capabilities and have the ability to access new text messages
  • have the ability to provide informed consent
  • have the ability to read and understand English

Exclusion Criteria:

  • have a pre-scheduled surgical procedure within the duration of the study
  • if it is expected that they will not survive the duration of the study due to non-cardiovascular reasons
  • are currently enrolled in another research project regarding CVDs that would interfere with the study outcomes.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Txt2Prevent
The treatment group will receive all the usual discharge treatment, instructions and information for acute coronary syndrome patients as well as the Txt2Prevent text-messaging program. The program will include a variety of topics such as standard follow-up care reminders as well as general self-management and healthy living texts. There will be two streams, one for current/recent smokers and one for non-smokers. Texts will be sent out every 1-3 days for 60 days. All participants in the same stream will receive the same texts in the same order.
Behavioral: Txt2Prevent
A 60-day text messaging program called Txt2Prevent (see description in the arm description).
No Intervention: Usual Care
The usual care group will receive all standard discharge treatment, instructions and information for patients with acute coronary syndrome, but no text-messaging program. Nurses typically go over important information with patients before they leave as well as give them printed materials.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Self-management as measured by the Health Education Impact Questionnaire by Osborne et al.
Time Frame: Pre- and post-study period (0 and 60 days)
Pre- and post-study period (0 and 60 days)

Secondary Outcome Measures

Outcome Measure
Time Frame
Medication Adherence as measured by the Morisky Medication Adherence Scale by Morisky et al.
Time Frame: Post-study period (60 days)
Post-study period (60 days)
Health-related quality of life as measured by the EuroQoL 5D-5L by the EuroQoL group
Time Frame: Pre- and post-study period (0 and 60 days)
Pre- and post-study period (0 and 60 days)
Hospital readmissions
Time Frame: Assessed at the end of the study (day 60)
Assessed at the end of the study (day 60)
Mortality
Time Frame: Assessed at the end of the study (day 60)
Assessed at the end of the study (day 60)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Simon Fraser University

Collaborators

University of British Columbia
Canadian Institutes of Health Research (CIHR)
McMaster University
Providence Health & Services

Investigators

  • Principal Investigator: Scott Lear, PhD, Simon Fraser University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

April 1, 2015

Primary Completion (Actual)

January 1, 2017

Study Completion (Actual)

January 1, 2017

Study Registration Dates

First Submitted

January 8, 2015

First Submitted That Met QC Criteria

January 12, 2015

First Posted (Estimate)

January 13, 2015

Study Record Updates

Last Update Posted (Actual)

April 26, 2017

Last Update Submitted That Met QC Criteria

April 24, 2017

Last Verified

April 1, 2017

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • H14-02385

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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