Department of Clinical Sciences Malmö, Lund University, Sweden.
Center for Primary Healthcare Research, Skåne University Hospital, Lund University, Sweden.
Scand J Prim Health Care. 2020 Sep;38(3):300-307. doi: 10.1080/02813432.2020.1794392. Epub 2020 Jul 20.
To evaluate the feasibility of a randomized controlled pilot study with lifestyle-promoting text messages as a treatment for hypertension in primary care.
Randomized controlled pilot trial.
Three primary health care centers in southern Sweden.
Sixty patients aged 40-80 years with hypertension were included.
Feasibility of the pilot study, i.e. recruitment rate, dropout rate and eligibility criteria. Secondary outcomes were change in blood pressure and other cardiovascular risk factors.
Thirty participants were randomized to the intervention group with four lifestyle-promoting text messages sent every week for six months. The control group received usual care. The baseline and follow-up visits for all 60 patients included measurements of blood pressure, anthropometrics, blood tests and a self-reported questionnaire.
All feasibility criteria (recruitment rate (≥55%), dropout rate (≤15%) and eligibility (60 eligible patients during the four-month inclusion period) for the pilot study were fulfilled. This means that a larger study with a similar design may be conducted. After six months, there were no significant improvements in cardiovascular risk factors. However, we found favorable trends for all secondary outcomes in the intervention group as compared to the control group.
Lifestyle modification in patients with hypertension is important to reduce cardiovascular risk. However, primary healthcare has limited resources to work with modifying lifestyle habits. This is the first pilot study to test the feasibility of text message-based lifestyle intervention in patients with hypertension in Swedish primary healthcare. Whether significant improvement in cardiovascular risk factors may be achieved in a larger study population remains to be evaluated. Key points This pilot randomized controlled trial (RCT) is the first study to evaluate the feasibility of text message-based lifestyle advice to patients with hypertension in Swedish primary healthcare. •All feasibility criteria for the pilot study were fulfilled. This outcome means that a larger study with a similar design may be conducted. •The study was not powered to find significant changes in cardiovascular risk factors. Nevertheless, after six months we found favorable trends for all secondary outcomes in the intervention group compared to control. •If a future larger study can show significant results, this intervention could serve as a useful tool in everyday primary healthcare.
评估将促进生活方式的短信作为初级保健中高血压治疗的随机对照试验的可行性。
随机对照试验。
瑞典南部的三个初级保健中心。
纳入 60 名年龄在 40-80 岁的高血压患者。
试验的可行性，即招募率、失访率和纳入标准。次要结果是血压和其他心血管危险因素的变化。
将 30 名参与者随机分为干预组，每周发送四条促进生活方式的短信，持续六个月。对照组接受常规护理。所有 60 名患者的基线和随访访视均包括血压、人体测量、血液检查和自我报告问卷的测量。
所有可行性标准（≥55%的招募率、≤15%的失访率和在四个月纳入期间有 60 名合格患者）都符合试验的要求。这意味着可以进行类似设计的更大规模研究。六个月后，心血管危险因素没有显著改善。然而，与对照组相比，我们发现干预组的所有次要结果都有有利的趋势。
改变高血压患者的生活方式对于降低心血管风险很重要。然而，初级医疗保健的资源有限，无法改变生活习惯。这是第一项在瑞典初级医疗保健中测试基于短信的生活方式干预对高血压患者可行性的试验研究。在更大的研究人群中是否可以实现心血管危险因素的显著改善仍有待评估。关键点：这是第一项在瑞典初级保健中评估基于短信的生活方式建议对高血压患者可行性的随机对照试验研究。所有可行性标准都满足了试验的要求。这一结果意味着可以进行类似设计的更大规模研究。这项研究没有足够的力量来发现心血管危险因素的显著变化。然而，六个月后，我们发现干预组的所有次要结果都比对照组有更好的趋势。如果未来的更大规模研究能够显示出显著的结果，这种干预措施可以作为日常初级保健中的有用工具。
