TEXT messages to improve MEDication adherence and Secondary prevention (TEXTMEDS) after acute coronary syndrome: a randomised clinical trial protocol

No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Background Identifying simple, low-cost and scalable means of supporting lifestyle change and medication adherence for patients following a cardiovascular (CV) event is important. Objective The TEXTMEDS (TEXT messages to improve MEDication adherence and Secondary prevention) study aims to investigate whether a cardiac education and support programme sent via mobile phone text message improves medication adherence and risk factor levels in patients following an acute coronary syndrome (ACS). Study design A single-blind, multicentre, randomised clinical trial of 1400 patients after an ACS with 12 months follow-up. The intervention group will receive multiple weekly text messages that provide information, motivation, support to adhere to medications, quit smoking (if relevant) and recommendations for healthy diet and exercise. The primary endpoint is the percentage of patients who are adherent to cardioprotective medications and the key secondary outcomes are mean systolic blood pressure (BP) and low-density lipoprotein cholesterol. Secondary outcomes will also include total cholesterol, mean diastolic BP, the percentage of participants who are adherent to each cardioprotective medication class, the percentage of participants who achieve target levels of CV risk factors, major vascular events, hospital readmissions and all-cause mortality. The study will be augmented by formal economic and process evaluations to assess acceptability, utility and cost-effectiveness. Summary The study will provide multicentre randomised trial evidence of the effects of a text message-based programme on cardioprotective medication adherence and levels of CV risk factors.This work is funded by a National Health and Medical Research Council (NHMRC) Project grant (ID APP1042290). CC is funded by a National Health and Medical Research Council of Australia Career Development Fellowship (APP1033478) co-funded by the Heart Foundation and a Sydney Medical School Foundation Chapman Fellowship. JR is funded by a Career Development and Future Leader Fellowship co-funded by the National Health and Medical Research Council and the National Heart Foundation (APP1061793). KS is funded by a University of Sydney International Postgraduate Scholarship. JT is funded by a University of Sydney Australian Postgraduate Award. SJ is funded by a NHMRC senior research fellowship (ID 1020430). RJ is funded by a Future Leader Fellowship funded by the National Heart Foundation (APP100484). KR is funded by a County Council of Östergötland international fellowship and the Swedish Medical Society