Text-messaging interventions help people quit smoking and improve medication use among HIV positive

Free C, Phillips G, Galli L, et al.  The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: A systematic review  PLOS Med. 2013; 10:1

Review question

How effective are mobile technology interventions at supporting health behaviour change and disease management for people who use health care services?

Background

Diseases such as diabetes, heart disease, lung cancer and HIV/AIDS are common causes of death world-wide. By practicing healthy behaviours, individuals may delay or reduce their risk of developing preventable diseases. Mobile technologies and text messaging may help health care providers to encourage healthy behaviours in people who use health care services.

How the review was done

This review included 75 studies with 17,538 participants. Health behaviour change studies aimed to increase physical activity, reduce food intake, and support quitting smoking. Disease management studies aimed to improve management and control of diabetes and HIV/AIDS, primarily through improved medication use.

The mobile technology interventions included text messages, emails, videos, electronic diaries or surveys. The purpose of the messages was to provide health information, motivation, a reminder, or promote goal setting.

What the researchers found

Overall the results were mixed depending on the type of intervention and outcome.

Health Behaviour change studies

Quit smoking. Participants who received a text message intervention were twice as likely to quit smoking as those who did not, at 1 month and 6 months after quitting.

Improving diet and increasing physical activity. Text-messaging to encourage physical activity improved the number of steps taken in a day and improved diabetes control, but did not reduce body weight. Text messages focused on improving diet and increasing physical activity together had no effect on body weight. However the quality of these studies was quite poor thereby limiting confidence in these results.

Disease management studies

The effect of mobile technology interventions are mixed, depending on the disease and the intervention.

Managing HIV treatment. In 1 study in a low-income country, text-messages helped people who were HIV positive stick to their treatment. This resulted in lower levels of the HIV virus, but did not reduce the chance of death.

Diabetes management. Text-messaging interventions improved blood sugar levels in people with diabetes.  However the quality of these studies was poor thereby limiting confidence in these results.

Conclusion

Text-message interventions may be useful to support people who want to quit smoking, and support compliance to treatment for people who are HIV positive in low-income countries.  Mobile technology may also people with diabetes and may improve activity levels, however more work needs to measure the effectiveness of tehse interventions.