Text Messaging Shows Promise in Reducing Cardiovascular Risk for Adults With Psoriasis
For many, psoriasis is viewed primarily as a skin condition. However, the medical community has long recognized that the systemic inflammation associated with psoriasis can increase the risk of cardiovascular disease. Managing this risk often requires significant lifestyle changes that can be difficult to maintain without consistent support.
A new study published in JAMA Dermatology suggests that a simple, low-intensity digital tool—text messaging—can effectively help patients improve their heart-health behaviors and take a more active role in their own care.
The Study: Using Digital Nudges for Heart Health
Researchers led by Annika Smith, M.B.B.S., Ph.D., from the University of Sydney, wanted to see if a structured text-messaging program could improve “patient activation” and reduce cardiovascular risk factors in adults living with psoriasis. Patient activation refers to a patient’s knowledge, skill, and confidence in managing their own health and care.
The clinical trial involved 111 adults with psoriasis who were randomly split into two groups: one receiving standard care and the other participating in a six-month text-messaging intervention.
Those in the intervention group received four semipersonalized text messages every week for 24 weeks. These messages weren’t random. they were specifically designed to target key health drivers, including:
- Dietary improvements and weight management
- Increasing physical activity
- Smoking cessation
- Medication adherence
- Education regarding both psoriasis and cardiovascular disease (CVD)
Key Findings: Where the Intervention Worked
The results indicated that consistent, brief reminders can lead to measurable behavioral changes. After six months, the group receiving text messages showed statistically significant improvements compared to the standard care group.
Behavioral and Knowledge Gains
The intervention group saw a notable boost in their ability to manage their health, with patient activation increasing by an adjusted mean difference of 10.8 points. The researchers observed:
- Increased Activity: Physical activity rose by an adjusted mean difference of 127.9 minutes per week.
- Better Nutrition: Adherence to the Mediterranean diet improved (adjusted mean difference of 1.7).
- Higher Knowledge: Knowledge regarding the link between psoriasis and CVD increased (adjusted mean difference of 6.6).
- Improved Compliance: Medication adherence saw an adjusted mean difference increase of 1.6.
Physical Changes
Beyond behavior, there was a tangible impact on weight, with the intervention group seeing a decrease in body mass index (BMI) by an adjusted mean difference of -1.0.
Understanding the Limitations
While the behavioral changes were significant, the study found that the impact on biological markers was more modest. There were no statistically significant differences between the two groups regarding:
- Lipid parameters (cholesterol levels)
- Hemoglobin A1c (blood sugar levels)
- Smoking behavior
- Psoriasis severity or dermatology-specific quality of life
The authors noted that while biomarker changes weren’t dramatic, the findings strongly support the use of digital tools as a helpful adjunct to traditional dermatology care.
- Digital Support Works: Low-intensity text messaging can improve patient activation and heart-healthy behaviors in psoriasis patients.
- Physical Activity Boost: Participants increased their weekly exercise by over two hours on average.
- Weight Management: The intervention led to a modest reduction in BMI.
- Adjunct Care: Digital tools are best used to supplement, not replace, standard medical treatment.
Expert Perspective: Why This Matters
From a clinical standpoint, the most important result is the increase in patient activation. When patients feel confident and informed, they’re more likely to stick to their medications and make the lifestyle pivots necessary to prevent heart disease. In a busy healthcare system, text messaging provides a scalable way to keep patients engaged between appointments.
This investigator-initiated study was supported by a grant from Sun Pharma.
Frequently Asked Questions
Why is cardiovascular risk higher in people with psoriasis?
Psoriasis is more than a skin condition; it’s a systemic inflammatory disease. This chronic inflammation can affect the blood vessels and increase the likelihood of developing cardiovascular issues, making lifestyle management critical.
Can I start a text-messaging program for my health?
While this specific study used a controlled, semipersonalized program, many healthcare providers now offer digital health portals or apps. You should discuss digital health tools and cardiovascular screening with your dermatologist or primary care physician.
Did the text messages cure psoriasis?
No. The study found that the intervention did not significantly change psoriasis severity or dermatology-specific quality of life; rather, it focused on reducing the associated cardiovascular risks.