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

Clara Chow, Aravinda Thiagalingam, Karla Santo, Cindy Kok, Jay Thakkar, Sandrine Stepien, Laurent Billot, Stephen Jan, Rohina Joshi, Graham Hillis, David Brieger, Derek Chew, Karin Radholm, John Atherton, Ravinay Bhindi, Nicholas Collins, Steven Coverdale, Christian Hamilton-Craig, Nadarajan Kangaharan, Andrew MaioranaMichelle McGrady, Pratap Shetty, Anthony Rogers, Julie Redfern

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13 Citations (Scopus)


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. Ethics and dissemination Primary ethics approval was received from Western Sydney Local Health District Human Research Ethics Committee (HREC2012/12/4.1 (3648) AU RED HREC/13/WMEAD/15). Results will be disseminated via peer-reviewed publications and presentations at international conferences. Trial registration number ACTRN12613000793718; Pre-results.

Original languageEnglish
Article numbere019463
Number of pages9
JournalBMJ Open
Issue number1
Publication statusPublished - 1 Jan 2018


  • cardiovascular risk factors
  • coronary heart disease
  • medication adherence
  • mhealth
  • secondary prevention
  • text message


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