The Challenges of Implementing a Text Message Intervention to Promote Behavioral Change in Primary Care Patients With Hypertension and Diabetes

Abstract Background Controlling blood pressure and glycemic levels is a challenge that requires innovative solutions. Objective To assess the feasibility of implementing a text message intervention among low-income primary care patients, as well as to assess self-reported behavioral change. Methods A set of 200 text messages was developed on healthy eating, physical activity, adherence, and motivation. Participants from Vale do Mucuri, MG, Brazil diagnosed with diabetes or hypertension or undergoing screening for those diseases, received 5 to 8 messages per week for 6 months. They answered a questionnaire to report their satisfaction and behavioral changes. Results Of the 136 patients, 117 (86.0%) answered the questionnaire. Most reported that the messages were very useful (86.3%), easy to understand (90.6%), and were very helpful for behavioral change (65.0%); 84.6% reported that they had started eating healthier. The most frequent reported lifestyle changes were: improved diet quality (85.5%), reduced portions (65.8%), and weight loss (56.4%). The majority of patients shared the messages (60.7%) with family or other acquaintances, considered the number of messages to be adequate (89.7%) and would recommend the program to others (95.7%). Conclusion An intervention based on text messages to promote behavioral change in patients with hypertension or diabetes in primary care is feasible in low-resource settings. Future studies are needed to assess the program's long-term effects on clinical outcomes.

Associaçäo esferocitose hereditária e traço falciforme: relato de um caso e revisäo da literatura / Hereditary spherocytosis associated with sickle cell trait: a case report and literature review

A associaçäo da esferocitose hereditária e o traço falciforme tem sido raramente relatado na literatura médica, com apenas 17 casos descritos que foram revistos neste trabalho. Apresentamos um caso adicional desta associaçä em paciente do sexo feminino, 21 anos, portadora do traço falciforme com história de anemia e crises de hemólise desde os sete anos de idade. Necessitou de hemoterapia em várias ocasiöes. Foi realizada ampla propedêutica, incluindo estudo familiar. Submetida a esplenectomia, houve melhora do quadro. Este caso enfatiza a necessidade de um estudo mais detalhado em pacientes portadores de traço falciforme com sinais evidentes de hemólise.