Conclusions
T2D, chronic kidney disease, CHD, Diabetes, diabetes
HEART, DIABETES, CHRONIC DISEASES, DIABETES
Mobile phone ownership is very high in many countries, even in low- and middle-income countries. This enables the delivery of health messages to a large population group, overcoming access barriers at a low cost. The telecommunications cost of delivering 4 SMS text messages per week for 6 months was in the order of Aus $6 (US $4.05) per participant. Thus, there is increasing interest in digital health interventions. SMS text messaging has also been trialed as an adjunct to routine care for people with a range of other chronic diseases other than CHD and diabetes, including chronic kidney disease [A key learning from this study is that SMS text messaging programs vary in their effectiveness and utility depending on the precise population and context. Our results do not indicate that SMS text messaging programs are generally ineffective in improving clinical metrics among people with T2D or CHD but that the goal may need to be tailored to the situation. Within an integrated care environment where there is already high-level care, SMS text messaging may provide other less tangible benefits. The co-design process of the SupportMe intervention with a multidisciplinary team and consumers facilitated the development of processes and content for the program as a whole. The high acceptability of the program across participants with multiple conditions indicates that the program can complement routine care by improving the patient experience and sense of engagement, which are important aspects of integrated care.Funding was provided by the New South Wales Translational Research Grants Scheme. JR was funded by a National Health and Medical Research Council (NHMRC) of Australia Career Development Fellowship (APP1143538). CKC was funded by a Career Development Fellowship cofunded by the NHMRC and the National Heart Foundation (APP1105447). RH was funded by a Westmead Hospital Jerry Koutts Scholarship. The funders were not involved in the design of the study; collection, analysis, and interpretation of the data; and writing of the report and did not impose any restrictions regarding its publication. This study was supported by the Western Sydney Local Health District, the National Heart Foundation, the New South Wales Agency for Clinical Innovation, Diabetes NSW & ACT (New South Wales & Australian Capital Territory), the University of Sydney, and the George Institute. Diabetes NSW & ACT supported and promoted the study and participated in message development.The contributors associated with The SupportMe Investigators are as follows: Nicola Barrie, David Burgess, Bridie Carr, Lily Chen, Michael Crampton, Cate Ferry, Peter Hay, Alison Hayes, Sheikh Mohammed Shariful Islam, Simon Raadsma, Chris Rissel, Gillian Rosic, N Wah Cheung, Jin-Gun Cho, Clara K Chow, Sonia Faruquie, Rabbia Haider, Tien-Ming Hng, Daniel McIntyre, Julie Redfern, Shelley She, Aravinda Thiagalingam, and Amy Von Huben.Conflicts of Interest: JR is part owner of Textcare IP and holds a National Health and Medical Research Council (NHMRC) Investigator Grant Leadership Level 2.Number of SMS text messages available for each health condition by topic addressed, questions used as a guide to facilitate focus group discussions, and example quotations illustrating the 5 major themes identified as enablers in SupportMe focus groups, respectively.SupportMe diet questionnaire.eCONSORT checklist.