Primary Care Usage of Health Promoting Messages

NCT ID: NCT04407962

Last Updated: 2023-07-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-01

Study Completion Date

2023-06-15

Brief Summary

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This project aims to investigate the use of e-health to assist health personnel in primary health care to carry out preventive measures of cardiovascular disease.The primary objective of the study is to examine the impact of lifestyle advices, administered through regularly sent SMS, on hypertension in a primary health care setting. The secondary objective is to evaluate changes in other cardiovascular risk factors and general health, e.g. tobacco use, obesity, blood lipids, HbA1c, self-rated health and health-related quality of life.

Detailed Description

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This is a randomised controlled multi-centre study.The study will involve 400 patients from 9 primary health care centres located in four different regions in Sweden (Region Skåne, Region Kronoberg, Region Stockholm, Västra Götalandsregionen).

Patients in the intervention group will receive SMS messages aiming to remind, encourage and motivate patients to pursue healthy lifestyle changes. After baseline measurement, participants in the intervention group will receive four semi-personalized SMS messages per week for six months, in addition to their usual anti-hypertensive treatment. Each week, the participants will receive SMS from each of the following groups: A. Physical activity, B. Tobacco use, C. Dietary habits, and D. Cardiovascular health in general, except for non-smokers who, instead of the tobacco use-SMS, will get one extra randomly selected SMS.

Included patients that consent to take part in the study will be invited to their primary health care centre for a baseline visit. The following measurements will be assessed by a research assistant: blood pressure (in sitting position after 5 minutes rest; mean of two measurements in a standardized procedure with validated electronic BP devices), BMI and waist-hip circumference. Furthermore, the patients will complete a short questionnaire for evaluation of medical history, medication, tobacco and alcohol use, physical activity level, self-rated health and health-related quality of life. Blood samples for HbA1c and cholesterol will be drawn. Randomization will be performed after completion of baseline assessments and questionnaires. A follow up control will be performed after 6 months with the same assessments as at the baseline visit.

The primary endpoint is change inblood pressure (mmHg). Secondary endpoints are changes in Cholesterol (total cholesterol, high-density lipoprotein \[HDL\], low-density lipoprotein \[LDL\]) (mmol/l), Tobacco and alcohol use, BMI (kg/m2), waist circumference, HbA1c (mmol/mol), Self-rated health (five-graded Likert scale), Health related quality of life, as measured by EQ5D-5L, Self-reported physical activity.

The power analysis indicates a sample size of 189 patients in each arm. The calculation is based on an assumed statistical power of 80%, a two-sided test, using a significant level of 5% with a difference of 4 mm Hg between the groups, a standard deviation of 13 mm Hg and a drop out rate of 15%. Data will be analyzed according to the intention-to-treat principle. Differences in mean change of endpoints between intervention and control groups will be calculated by ANCOVA, with baseline values as covariates. Correlation between behavioral change (smoke cessation,increased level of physical activity) and behavioral predictors will be analyzed with logistic regression analysis.

Conditions

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Hypertension Cardiovascular Risk Factor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized Controlled Trial
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Caregivers Investigators Outcome Assessors

Study Groups

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SMS group

Participants in the intervention group will receive four semi-personalized messages per week in addition to their usual care according to the National Board of Health and Welfare guidelines for hypertension treatment.

Group Type EXPERIMENTAL

SMS group

Intervention Type BEHAVIORAL

The experimental treatment will consist of health promoting text messages addressing metabolic risk factors associated with cardiovascular disorders in patients with hypertension. The text messages will be developed to support healthy life style changes i.e. regarding general cardiovascular health, tobacco use, physical activity and diet.

Control group

The control group will receive usual care according to the National Board of Health and Welfare guidelines for hypertension treatment.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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SMS group

The experimental treatment will consist of health promoting text messages addressing metabolic risk factors associated with cardiovascular disorders in patients with hypertension. The text messages will be developed to support healthy life style changes i.e. regarding general cardiovascular health, tobacco use, physical activity and diet.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Patients with hypertension (defined by the International classification of disease Manual ICD-10, diagnose code I10.9)
2. 40-85 years
3. Patient must own a smart mobile phone

Exclusion Criteria

1. Blood pressure at baseline visit ≥180/110 mmHg or systolic blood pressure\<120 mmHg
2. Serious illness with short life expectancy (\<1year)
3. Predicted inability to comply with the study protocol e.g. language difficulties, interpreter needs, serious cognitive impairment
4. Pregnancy
Minimum Eligible Age

40 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Lund University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Bokskogens Health Care Center

Bara, , Sweden

Site Status

Laröds Health Care Center

Helsingborg, , Sweden

Site Status

Vårdcentralen Delfinen

Höganäs, , Sweden

Site Status

Vårdcentralen Nötkärnan

Kållered, , Sweden

Site Status

Nöbbelövs Health Care Center

Lund, , Sweden

Site Status

Rävlanda vårdcentral

Rävlanda, , Sweden

Site Status

Närhälsan Tidaholm

Tidaholm, , Sweden

Site Status

Skärvet Health Care Center

Vaxjo, , Sweden

Site Status

Hovshaga Health Care Center

Vaxjo, , Sweden

Site Status

Countries

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Sweden

References

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NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. Lancet. 2017 Jan 7;389(10064):37-55. doi: 10.1016/S0140-6736(16)31919-5. Epub 2016 Nov 16.

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Reference Type BACKGROUND
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Brodin N, Wolff M, Borgstrom Bolmsjo B, Milos Nymberg V, Nymberg P, Calling S. Factors associated with blood pressure control in Swedish primary care patients with hypertension: a cross-sectional study. Scand J Prim Health Care. 2025 Jun 30:1-9. doi: 10.1080/02813432.2025.2524366. Online ahead of print.

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Other Identifiers

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2019-06361

Identifier Type: -

Identifier Source: org_study_id

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