SMS-based Lifestyle Intervention for Patients With Liver Cirrhosis With Previous Hepathic Encephalopathy
SMS-based Lifestyle Intervention for Patients With Liver Cirrhosis With Previous Hepathic Encephalopathy
To investigate whether simple reminders about healthy lifestyle sent via mobile phone text
 messages can improve the liver cirrhosis severity and prognosis (as assessed by the MELD
 score supported by the Child-Pugh score) among patients with liver cirrhosis that have been
 through a 12-week supervised and facility-based physical exercise training program and
 in-patient rehabilitation.
Physical exercise and other interventions focused on lifestyle factors have not only the
 potential to increase physical functioning and capacity, but also to affect fundamental
 aspects of disease, increase quality of life, and may even increase survival in patients with
 liver cirrhosis.

 Instruction and advice about a healthy lifestyle and physical activity are attractive as it
 limits time spent on supervised rehabilitation at an outpatient clinic. Further,
 self-management can be attractive to society as it can conserve health care resources.
 However, instructions and advice can only be effective if the patients adhere to them, and
 there is a need for initiatives that enhance the motivation to follow the advice and change
 undesirable behaviours.

 Mobile phone short-message service (SMS) messages are increasingly used to deliver
 interventions and enhance healthy behaviour. The technology is simple, cost-effective, can be
 automated, and can reach any mobile phone owner. In a recent systematic review, SMS-messages
 have been shown effective in a broad range of healthy behaviours, which was also highlighted
 in a randomized trial showing positive effects of lifestyle-focused SMS-messages on
 cardiovascular risk factors in patients with coronary heart disease. An SMS-message-based
 lifestyle intervention therefore seems like a feasible and effective means of enhancing
 motivation to follow advice about healthy lifestyle and physical activity among patients with
 liver cirrhosis.
Inclusion Criteria:

 1. Adult, i.e. age 18 years or above.

 2. Is attending the liver cirrhosis rehabilitation clinic at Bispebjerg hospital; i.e.,
 has alcohol-induced liver cirrhosis or hepatorenal syndrome and has at least once
 experienced severe decompensation in the form of hepatic encephalopathy or variceal
 haemorrhage.

 3. Has attended at least 50% of the scheduled sessions in the 12 week run-in physical
 exercise program

 4. Is the owner of a mobile phone capable of receiving SMS-messages

 5. Has signed informed consent

 6. Reads and speaks Danish

 Exclusion Criteria:

 1. Any condition that in the opinion of the investigator puts an otherwise eligible
 participant at increased risk by participation or otherwise make the person unfit for
 participation