Treatment adherence
Do heart texts improve lifestyle adherence?
Open access · cc by · source: Europe PMC
A text-and-internet cardiac rehab program improved short-term lifestyle adherence after CHD, but the benefit faded by 6 months.
Study at a glance
- Design
- RCT — Text4Heart 24-week mHealth cardiac rehabilitation plus usual care vs usual care alone
- N
- N=123 · 61 intervention, 62 control
- Population
- New Zealand adults with coronary heart disease
- Outcome
- Adherence to recommended lifestyle behaviours at 3 and 6 months
Structured fields used in claim comparison tables when every cited study has a complete layer.
Key findings
Lifestyle adherence rose more in the intervention arm at 3 months (AOR 2.55) but the difference was not significant at 6 months. Medication adherence scores were better with Text4Heart; LDL differences were borderline.
Methodology
New Zealand adults with coronary heart disease were randomized to usual care plus a 24-week Text4Heart mHealth cardiac rehabilitation program or usual care alone. Researchers tracked adherence to recommended lifestyle behaviours at 3 and 6 months plus medication adherence and lipids.
Limitations
The trial was modest in size, relied on self-reported behaviours for the primary outcome, and does not prove fewer hard cardiac events over long follow-up.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
Behaviour-change RCTs in this set often show a clear advantage while the intervention is running and a weaker or gone contrast once it stops. Insufficiently active adults randomised to a 50-day Facebook walking programme increased walking by about 155 min/week during the programme, but between-group advantages were not maintained three months after the app ended; Text4Heart raised lifestyle adherence at 3 months (AOR 2.55) without a significant 6-month difference.
Evidence for the claim as stated.
Unblinded patient-reported outcomes and attention effects pull in the opposite direction from hard clinical events. Phone telemonitoring improved MLHFQ in a 100-person heart-failure trial that was not powered for hospitalisation or death, while Text4Heart's lifestyle gains were self-reported and LDL differences were only borderline.
Evidence for the claim as stated.
A randomised AOR can still fade. New Zealand adults with coronary heart disease assigned to Text4Heart had higher lifestyle-adherence odds at 3 months (AOR 2.55) that were no longer significant at 6 months. Medication-adherence scores improved; LDL differences were only borderline. The trial was modest, relied on self-report for the primary behaviour outcome, and does not prove fewer hard cardiac events.
Evidence for the claim as stated.
The same odds-ratio language is asked to do two different jobs. Senegal's AOR 3.10 and the CDI 36% excess odds are observational associations after covariate adjustment. Text4Heart's AOR 2.55 is a randomised contrast that itself was gone by 6 months. Reading every AOR as if it were that trial overclaims the survey papers and understates how fragile a trial AOR can be once follow-up continues.
Evidence for the claim as stated.
Open questions
Tensions this paper is part of
From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.
Unblinded patient-reported outcomes and attention effects pull in the opposite direction from hard clinical events. Phone telemonitoring improved MLHFQ in a 100-person heart-failure trial that was not powered for hospitalisation or death, while Text4Heart's lifestyle gains were self-reported and LDL differences were only borderline.
- Supports · Phone telemonitoring in heart failure
The same odds-ratio language is asked to do two different jobs. Senegal's AOR 3.10 and the CDI 36% excess odds are observational associations after covariate adjustment. Text4Heart's AOR 2.55 is a randomised contrast that itself was gone by 6 months. Reading every AOR as if it were that trial overclaims the survey papers and understates how fragile a trial AOR can be once follow-up continues.
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