You are here

  • Home
  • Archive
  • Volume 9, Issue 2
  • Effect of text messaging on depression in patients with coronary heart disease: a substudy analysis from the TEXT ME randomised controlled trial

Article Text

Article menu

Download PDFPDF

XML
Epidemiology
Research
Effect of text messaging on depression in patients with coronary heart disease: a substudy analysis from the TEXT ME randomised controlled trial
  1. Sheikh Mohammed Shariful Islam1,2,3,
  2. Clara K Chow1,2,4,
  3. Julie Redfern1,2,
  4. Cindy Kok1,
  5. Karin Rådholm1,5,
  6. Sandrine Stepien1,
  7. Anthony Rodgers1,2,
  8. Maree L Hackett1,6,7
  1. 1 The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  2. 2 Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
  3. 3 Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Victoria, Australia
  4. 4 Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
  5. 5 Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden
  6. 6 School of Health, The University of Central Lancashire, Preston, UK
  7. 7 School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Professor Clara K Chow; clara.chow{at}sydney.edu.au

Abstract

Objective We aimed to evaluate the effects on depression scores of a lifestyle-focused cardiac support programme delivered via mobile phone text messaging among patients with coronary heart disease (CHD).

Design Substudy and secondary analysis of a parallel-group, single-blind randomised controlled trial of patients with CHD.

Setting A tertiary hospital in Sydney, Australia.

Intervention The Tobacco, Exercise and dieT MEssages programme comprised four text messages per week for 6 months that provided education, motivation and support on diet, physical activity, general cardiac education and smoking, if relevant. The programme did not have any specific mental health component.

Outcomes Depression scores at 6 months measured using the Patient Health Questionnaire-9 (PHQ-9). Treatment effect across subgroups was measured using log-binomial regression model for the binary outcome (depressed/not depressed, where depressed is any score of PHQ-9 ≥5) with treatment, subgroup and treatment by subgroup interaction as fixed effects.

Results Depression scores at 6 months were lower in the intervention group compared with the control group, mean difference 1.9 (95% CI 1.5 to 2.4, p<0.0001). The frequency of mild or greater depressive symptoms (PHQ-9 scores≥5) at 6 months was 21/333 (6.3%) in the intervention group and 86/350 (24.6%) in the control group (relative risk (RR) 0.26, 95% CI 0.16 to 0.40, p<0.001). This proportional reduction in depressive symptoms was similar across groups defined by age, sex, education, body mass index, physical activity, current smoking, current drinking and history of depression, diabetes and hypertension. In particular, the rates of PHQ-9 ≥5 among people with a history of depression were 4/44 (9.1%) vs 29/62 (46.8%) in intervention vs control (RR 0.19, 95% CI 0.07 to 0.51, p<0.001), and were 17/289 (5.9%) vs 57/288 (19.8%) among others (RR 0.30, 95% CI 0.18 to 0.50, p<0.001).

Conclusions Among people with CHD, a cardiac support programme delivered via mobile phone text messaging was associated with fewer symptoms of mild-to-moderate depression at 6 months in the treatment group compared with controls.

Trial registration number ACTRN12611000161921.

  • text message
  • mobile phones
  • cardiovascular diseases
  • mental health
  • diabetes
  • hypertension
  • coronary heart diseases

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-022637

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Twitter @drsislam

    • Contributors CKC and SMSI had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses. Study concept and design: CC, MLH, JR, AR. Analyses and interpretation of data: SMSI, CKC, SS, MH. Drafting of the manuscript: SMSI, CKC, MLH, CK, SS, KR. Critical revision of the manuscript for important intellectual content: all authors. The first and the corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

    • Funding This work was supported by peer-reviewed grants from the National Heart Foundation of Australia Grant-in-Aid (G10S5110) and a BUPA Foundation Grant. CKC is funded by a Career Development Fellowship co-funded by the National Health and Medical Research Council (NHMRC) (1033478) and National Heart Foundation (11S6016) and Sydney Medical Foundation Chapman Fellowship. SMSI is supported by a Senior Research Fellowship funded by Institute for Physical Activity and Nutrition (IPAN), Deakin University and has received funding from High Blood Pressure Research Council of Australia. JR is funded by a NHMRC Career Development Fellowship (1061793) co-funded with a National Heart Foundation Future Leader Fellowship (G160523). MLH is funded by a National Heart Foundation Future Leader Fellowship, Level 2 (100034: 2014–2017).

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Western Sydney Local Health Network Human Research Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Patient-level data and statistical code available from the corresponding author at reasonable request. Consent for data sharing was not obtained but the presented data are anonymised and risk of identification is low.