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In patients with cardiovascular diseases, comprehensive risk factor control and lifestyle modification reduce the risk of recurrent events and the need for revascularisation procedures, and improve survival and quality of life.1 Despite this convincing evidence, in the real world, there are several barriers that hamper the application of such measures and prevent patients from benefiting from measures that reduce cardiovascular risk. Non-adherence to preventive and therapeutic lifestyle recommendations remains a special challenge in the management of these patients.2 This challenge requires innovative management strategies.
This brings into focus the great advances in telecommunication technology and information technology, including the fast expansion of mobile technology. The ubiquity, mobility and affordability of mobile technology offer the potential to transform worldwide delivery of health services and improve health systems. Short message service (SMS) may be applied to different purposes (reminder, alert, education, motivation and prevention) and has shown positive impact on clinical outcomes, adherence to treatment and care, health behaviour changes, disease management and attendance rates,3 but evidence of cost-effectiveness was scarce.
In their Heart publication, Burnet al4 fill an important gap as they provide a cost-effectiveness analysis of an SMS strategy and its estimated impact in health systems’ costs by analysing data from the Tobacco, Exercise and Diet Messages (TEXT ME) trial study.5 The TEXT ME trial was a randomised clinical trial that assessed the effectiveness of lifestyle-focused semipersonalised SMS sent four times a week, in a sample of patients with coronary heart disease (CHD) in Australia. The text messages provided support, advice, information and motivation on diet, physical activity and smoking cessation. After 6 months, there was a significant decrease in low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP) and body mass index (BMI), besides a significant enhancement in physical activity and reduction of smoking. …
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