ITM support for patients with chronic respiratory and cardiovascular diseases: a protocol for a randomised controlled trial

Julie Redfern, Karice Hyun, Anna Singleton, Nashid Hafiz, Rebecca Raeside, Lissa Spencer, Bridie Carr, Ian Caterson, John Cullen, Cate Ferry, Karla Santo, Alison Hayes, Regina W M Leung, Simon Raadsma, Jessica Swinbourne, Jin G Cho, Meredith King, Mary Roberts, Cindy Kok, Christine Jenkins, Clara Chow, Julie Redfern, Karice Hyun, Anna Singleton, Nashid Hafiz, Rebecca Raeside, Lissa Spencer, Bridie Carr, Ian Caterson, John Cullen, Cate Ferry, Karla Santo, Alison Hayes, Regina W M Leung, Simon Raadsma, Jessica Swinbourne, Jin G Cho, Meredith King, Mary Roberts, Cindy Kok, Christine Jenkins, Clara Chow

Abstract

Introduction: Simple and scalable strategies are needed to improve 'out-of-hospital' support and management for people living with cardiovascular disease (CVD) and respiratory disease. Text messaging via mobile phones has been shown to be effective in helping promote lifestyle change and is supported by quantitative and qualitative evidence. The aim of this study is to test the effectiveness and implementation of a 6-month text messaging support programme for people with CVD and respiratory disease as an addition to cardiac and pulmonary outpatient rehabilitation.

Methods and analysis: Pragmatic randomised controlled trial (n=310) to test the effectiveness of a 6-month text message support programme on clinical outcomes in people with CVD and chronic respiratory disease who are attending outpatient cardiac and pulmonary rehabilitation. The study includes a nested process evaluation to inform scalability and implementation across settings. The intervention group will receive a text message support programme comprising five messages per week for 26 weeks and the control group will continue with standard care. The primary outcome is exercise capacity (6 min walk distance). Secondary outcomes include clinical measures (proportion of people meeting the Australian guideline-recommended blood pressure and cholesterol targets), lifestyle outcomes (smoking rates, achievement of national guidelines for nutrition and physical activity), quality of life, mood (Hospital Anxiety and Depression Scale), medication adherence and attendance at and completion of rehabilitation.

Ethics and dissemination: Primary ethics approval was received from the Sydney Local Health District Hospital Human Research Ethics Committee and associated Governance committees at sites. Results will be disseminated via the usual scientific forums including peer-reviewed publications and presentations at international conferences. At its conclusion, the study will determine the effectiveness and implementation of a simple programme that aims to improve health outcomes and attendance at rehabilitation for people with CVD and chronic respiratory disease.

Trial registration number: ACTRN12616001167459.

Keywords: cardiovascular disease; chronic obstructive pulmonary disease; implementation; rehabilitation medicine; respiratory medicine (see thoracic medicine); text message.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Study flow diagram. LDL, low-density lipoprotein; BMI, body mass index; CV, cardiovascular.

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