Sending four text messages a week significantly improves patient activation and lifestyle behaviours in psoriasis patients, but does not seem to shift cardiometabolic markers, Australian research shows.

The TEXTME PSO trial recruited 111 patients with psoriasis and randomised them to receive semi-personalised weekly texts for six months, covering Mediterranean diet principles, physical activity, smoking cessation and weight management. The control group received standard care.

After 24 weeks, the intervention group showed:

• A significant improvement in patient activation, scoring 10.8 points higher on the 13-point Patient Activation Measure than controls
• Greater adherence to the Mediterranean diet, better medication adherence and improved psoriasis knowledge
• Increased weekly exercise minutes and reduced BMI

Dr Annika Smith.

However, the study found no between-group differences in lipid levels, HbA1c, smoking cessation, dermatology-specific quality of life or psoriasis severity.

Writing in JAMA Dermatology [link here], dermatologist Dr Annika Smith and colleagues from the University of Sydney said the short study duration and low intervention intensity may explain the lack of cardiometabolic effect.

“While [text message] interventions can improve patient activation and lifestyle behaviours, clinically meaningful cardiometabolic effects may require a multimodal approach combining digital tools with structured lifestyle programs, medication review, and clinician reinforcement,” they wrote.

The authors noted that parallel gains in psoriasis CVD knowledge and medication adherence suggested targeted educational messaging could support self-management across multiple domains.

They argued that for a population at elevated cardiovascular risk, and in the absence of definitive evidence that systemic therapies reduce that risk, low-intensity digital tools may offer a practical first step, with foundational prevention focused on education and behavioural change likely to deliver the most immediate gains.