Experts are advocating for the development of Australia's first-ever heart disease screening program after a randomised controlled trial found a significant increase in people receiving heart health checks with their doctor after being 'nudged' with text messages.
The Heart Foundation's Text to Detect program was informed by a longstanding research partnership with the University of Sydney. The trial showed that patients who received an SMS invitation followed by a reminder 'nudge' were up to 15 times more likely to see their GP for a Medicare-funded Heart Health Check than those who received no message.
The study findings, published in Lancet Primary Care strengthen the case for a national cardiovascular risk screening program.
About the study
160 general practices from across Australia participated in the randomised controlled trial. Almost half of these general practices were located in regional or remote areas, and one in five clinics were located in the most disadvantaged areas.
Over a three month period, more than 70,000 SMS invitations were sent to at-risk patients aged between 45 and 74 who had not recently had a cholesterol test or heart health assessment.
Not only were the text messages associated with a greater uptake of Heart Health Checks, but they were also associated with increased measurement of cholesterol, blood pressure, diabetes and weight related measures compared to control.
Post-hoc analysis of the data also revealed that the invitation and reminder messages were associated with increased prescription of important preventative medicines for high cholesterol in larger general practices, compared to control.
"The trial results show that a simple SMS from your GP can address longstanding barriers to Heart Health Checks," said Associate Professor Carissa Bonner from the School of Public Health , who was a scientific adviser on the program and led consumer testing of the model.
"Australia has a Medicare-subsidised Heart Health Check if you're 45 or older, but there is currently no national screening program to invite higher risk patients to get a check. This study shows how a simple 'digital nudge' from GPs can increase Heart Health Checks by 15 times the usual rate," she said.
The Heart Foundation's Senior Manager for Healthcare Programs and Clinical Strategy, Natalie Raffoul, said that the findings showed the power of low-cost digital reminders in preventing heart disease.
"This is the strongest evidence yet that a structured, targeted, screening program for heart disease is both feasible and effective in primary care. A simple text message can save lives, and now we know it works at scale.
"General practices are best placed to deliver this kind of critical preventative care and we are so thankful to the thousands of GPs, nurses and general practice staff who have been involved in our pilot activity to date," she said.
Professor Bonner, a member of the Charles Perkins Centre , added: "We first documented barriers to heart health checks when the original cardiovascular disease risk management guidelines for Australia were released in 2012. A key issue was the lack of patient knowledge about these checks, combined with limited consultation time to focus on heart health checks at the GP.
"This SMS model addresses the patient awareness side, using health literacy friendly SMS nudges to ensure heart health checks are accessible to everyone. Importantly, we used behavioural science principles to close the uptake gap between people with lower and higher health literacy.
"This new model provides a template to improve the uptake of cardiovascular prevention guidelines, paving the way for a national targeted risk screening program for Australia."
Next steps: designing a national cardiovascular screening program
On the back of the findings, the Heart Foundation will commence the design of an affordable and effective national program to systematically screen Australians for heart disease risk. They will work with the sector to develop affordable and effective targeted screening program options and will make the case to the Australian Government for their implementation.
The announcement comes as Australia reaches a major milestone - one million Heart Health Checks have now been delivered by GPs, since the Medicare item was introduced in 2019.
Research
Raffoul, N., Brimms, K., Knight, J., Nelson, A.J., Asham, A., Bonner, C., 'Targeted cardiovascular risk screening through an SMS programme (Text to Detect) in general practice: a three-arm, parallel group, randomised controlled trial' (Lancet Primary Care, 2025)
