Effectiveness of text messages in improving cardiac rehabilitation adherence among patients with coronary heart disease: An Integrative Review.

Abstract

Abstract Background CHD is a major medical condition resulting in a high proportion of deaths globally. It can lead to severe cardiac complications, including sudden death and heart failure. An unhealthy lifestyle and low adherence to medication regimens can add to the severity of a patient’s disease, increasing their risk of CHD related mortality. Secondary prevention measures, such as CR, are playing a vital role in modifying risk factors and improving medication adherence. However, due to several barriers, the uptake of CR remains sub optimal. To address these barriers, a variety of models are currently being developed, one of which is mHealth. This review investigates the efficiency of text messages as a tool to improve CR adherence among patients with CHD. Method: A database search was conducted through Queen’s University of Belfast Electronic Library. Databases including: (1) PubMed; (2) (Embase); (3) Cochrane; (4) (CINAHL); and (5) OVID MEDLINE were searched between January 2010 and May 2020. The review includes only Randomised Control Trails (RCTs) using text messaging (TM) as an intervention, to assess this method’s effectiveness at improving CR adherence. Result: The database search returned 1230 studies, with only eight papers meeting the inclusion criteria. Of these eight studies, three assessed TM efficacy in improving medication adherence, four investigated TM's capability to modify risk factors, and one assessed TM's efficacy for assisting CHD patients with comorbidities. The analysis of the included studies found TM helps improve adherence to CR among CHD patients, especially in the areas of medication adherence and modifying risk factors. Conclusion: TM encourages patients with CHD to adhere to healthy behaviours by providing individualised support that extends continuation of care beyond traditional CR. Therefore, it could be viewed as a replacement for traditional CR, and a suppurating aid of particular value to inhabitants of rural areas.