Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

A mobile health intervention to increase physical activity in pulmonary arterial hypertension
Hemnes AR, Silverman-Loyd L, Huang S, MacKinnon G, Annis J, Whitmore CS, Mallugari R, Oggs RN, Hekmat R, Shan R, Huynh PP, Yu C, Martin SS, Blaha MJ, Brittain EL
Chest 2021 Sep;160(3):1042-1052
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Supervised exercise training improves outcomes in patients with pulmonary arterial hypertension (PAH). The effect of an unsupervised activity intervention has not been tested. RESEARCH QUESTION: Can a text-based mobile health intervention increase step counts in patients with PAH? STUDY DESIGN AND METHODS: We performed a randomized, parallel arm, single-blind clinical trial. We randomized patients to usual care or a text message-based intervention for 12 weeks. The intervention arm received three automated text messages per day with real-time step count updates and encouraging messages rooted in behavioral change theory. Individual step targets increased by 20% every four weeks. MEASUREMENTS: The primary endpoint was mean week 12 step counts. Secondary endpoints included the six minute walk test, quality of life, right ventricular function, and body composition. RESULTS: Among 42 randomized participants, the change in raw steps between baseline and week 12 was higher in the intervention group (1,409 steps (IQR -32 to 2,220) versus -149 steps (IQR -1,010 to 735); p = 0.02), which persisted after adjustment for age, sex, baseline step counts, and functional class (model estimated difference 1,250 steps, p = 0.03). The intervention arm took a higher average number of steps on all days between days 9 to 84 (p < 0.05 all days). There was no difference in week 12 six minute walk distance. Analysis of secondary endpoints suggested improvements in the emPHasis-10 score (adjusted change -4.2, p = 0.046), a reduction in visceral fat volume (adjusted change -170 ml, p = 0.023), and nearly significant improvement in tricuspid annular plane systolic excursion (Model estimated difference 1.2 mm, p = 0.051). INTERPRETATION: This study demonstrated the feasibility of an automated text message-based intervention to increase physical activity in patients with PAH. Additional studies are warranted to examine the effect of the intervention on clinical outcomes.

Full text (sometimes free) may be available at these link(s):      help