Imagine you received this text message from your doctor one afternoon: “Hi. Have you gone for your walk today?” Do you think this would make you more likely to go for a walk?

If you’re sceptical that text message reminders could actually help you make healthier lifestyle choices, you’re not alone. But it turns out that you’re also wrong.

As NPR reports, text reminders help people lower cholesterol and blood pressure
As NPR reports, text reminders help people lower cholesterol and blood pressure

According to a study published last month in the Journal of the American Medical Association (JAMA), text message reminders helped patients with coronary heart disease achieve better health outcomes. As NPR reports, in a randomized clinical trial at Westmead Hospital in Sydney, Australia, 700 patients with coronary heart disease were divided into two groups, half receiving informative and motivating text messages in addition to otherwise normal care. After six months, the patients who received the text messages had reduced their blood pressure, cholesterol and body mass index.

“These are the things that medications usually do, not text messages,” said Clara Chow, the lead author on the study, who said she was surprised by the results. However, a separate study from August also found that text message reminders improved patient outcomes, in this case for patients with diabetes.

The Mobile Insulin Titration Intervention (MITI) was conducted with 33 insulin-dependent diabetes patients at New York’s Bellevue Hospital, which has traditionally served the city’s poor. People with insulin-dependent diabetes usually have to make a series of doctor’s office visits to fine-tune their daily dosage, which can be hard for patients who don’t have paid sick leave or are struggling to support a family. Recognizing this problem, a professor in the NYU School of Medicine piloted MITI to help her low-income diabetes patients adjust their insulin doses remotely.

Selected patients got a morning reminder to take a blood sugar reading and text the value back. The MITI study group also got weekly phone calls from a nurse, while a similar-size comparison group received traditional care, which involves more frequent in-person visits. As NPR reports, the study found that 88 percent of the MITI patients got their blood sugars within an acceptable range after 12 weeks, compared to 37 percent in the control group.

The idea that simple text message reminders (and the occasional phone call) can significantly improve health outcomes flies in the face of recent hype around fancy fitness trackers and smartphone health apps. There’s little evidence showing improved health outcomes from the more than 100,000 mhealth apps on the market, and even pedometers don’t get people moving if their disinclined to exercise.

These findings – that text messages are doing what these fitness apps haven’t – are especially important because they demonstrate successful interventions that could reach across sectors of the population that don’t own smartphones. While less than two-thirds of American adults own a smartphone, 90% own some kind of cell phone. While nearly all of the patients in the MITI study at Bellevue Hospital owned a cell phone, less than half owned a smartphone.

These particular studies are also important because the we are seeing increasingly high rates of heart disease and diabetes in the United States as well as globally. Cardiovascular disease is the leading cause of death, and in the United States it accounts for 1 in every 4 deaths, or 610,000 annually according to the CDC. Diabetes is on the rise, with 21.3 million American adults diagnosed. The CDC estimates that 1 out of every 3 adults in the United States could have diabetes by 2050.

Public hospitals in New York City are now looking into improving and expanding MITI protocol to a much larger pool of diabetic patients.

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