Impact of personalized text messages from pharmacists on medication adherence in type 2 diabetes in France: A real-world, randomized, comparative study

2021 ◽  
Author(s):  
Jean-François Gautier ◽  
Christian Boitard ◽  
Yves Michiels ◽  
Gerard Raymond ◽  
Geoffroy Vergez ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Comparative Study ◽  
Real World ◽  
Text Messages

scholarly journals Combining Wireless technology and Behavioral Economics to Engage Patients with cardiometabolic disease (WiBEEP): A Pilot Study (Preprint)

2017 ◽  
Author(s):  
Edith Angellotti ◽  
John Wong ◽  
Ayal Pierce ◽  
Benjamin Hescott ◽  
Anastassios Pittas
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Pilot Study ◽  
Behavioral Economics ◽  
Text Messages ◽  
Cardiometabolic Disease ◽  
Wireless Technology ◽  
Cardiometabolic Diseases

BACKGROUND The long-term management of cardiometabolic diseases, such as type 2 diabetes and hypertension, is complex and can be facilitated by supporting patient-directed behavioral changes. The concurrent application of wireless technology and personalized text messages (PTMs) based on behavioral economics in managing cardiometabolic diseases although promising, has not been studied. OBJECTIVE The aim of this pilot study was to evaluate the feasibility and acceptability of the concurrent application of wireless home blood pressure (BP) monitoring (as an example of “automatic hovering”) and PTMs (as an example of “nudging”) targeting pharmacotherapy and lifestyle habits in patients with type 2 diabetes and/or hypertension. METHODS The Wireless technology and Behavioral Economics to Engage Patients with cardiometabolic disease (WiBEEP) study was a single-arm, open-label, 7-week long pilot study in 12 patients (age 58.5 y) with access to a mobile phone. The study took place at Tufts Medical Center (Boston, MA) between March and September 2017. All patients received PTMs; nine patients received wireless home BP monitoring. At baseline, patients completed questionnaires to learn about their health goals and to assess medication adherence; at the end of week 7, all participants completed questionnaires to evaluate the feasibility and acceptability of the intervention and assess for medication adherence. Hemoglobin A1c was ascertained from data collected during routine clinical care in 7 patients. RESULTS The majority of patients reported the texts messages to be easy to understand (88%), appropriate in frequency (71%) and language (88%). All patients reported BP monitoring to be useful. Mean arterial pressure was lower at the end-of-study compared to baseline (-3.4 mmHg [95% CI, -5 to -1.8]. Mean change in HbA1c was -0.31% [95% CI, -0.56 to -0.06]. CONCLUSIONS Among patients with type 2 diabetes and/or hypertension the combination of wireless BP monitoring and lifestyle-focused text messaging was feasible and acceptable. Larger studies will determine the long-term effectiveness of such an approach.

scholarly journals Use of Brief Messages Based on Behavior Change Techniques to Encourage Medication Adherence in People With Type 2 Diabetes: Developmental Studies (Preprint)

2019 ◽  
Author(s):  
Yvonne Kiera Bartlett ◽  
Andrew Farmer ◽  
Rustam Rea ◽  
David P French
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Behavior Change ◽  
Health Care Professionals ◽  
Text Messages ◽  
Test Theory ◽  
Behavior Change Techniques ◽  
Adherence To Medication ◽  
Adherence Support

BACKGROUND Brief messages are a promising way to improve adherence to medication for people with type 2 diabetes. However, it is often unclear how messages have been developed and their precise content, making it difficult to ascertain why certain messages are successful and some are not. OBJECTIVE The goal of the research was to develop messages that have proven fidelity to specified evidence-derived behavior change techniques (BCTs) and are acceptable to people with type 2 diabetes. METHODS Four studies were conducted: (1) a workshop (n=21) where behavioral change researchers and health care professionals developed messages based on specific BCTs or beliefs or concerns related to taking medication, (2) a focus group study with people with type 2 diabetes (n=23) to assess acceptability of the approach, (3) a survey to ascertain the acceptability of a subset of messages to people with type 2 diabetes (n=61) and, (4) a survey with behavior change researchers to assess the fidelity of a subset of messages to their intended BCT (n=18). RESULTS In study 1, 371 messages based on 38 BCTs and beliefs/concerns were developed. Workshop participants rated BCTs to be relevant to medication adherence (mean 7.12/10 [SD 1.55]) and messages to have good fidelity (mean 7.42/10 [SD 1.19]). In study 2, the approach of providing medication adherence support through text messages was found to be acceptable. In study 3, mean acceptability of all BCTs was found to be above the midpoint (mean 3.49/5 [SD 0.26]). In study 4, mean fidelity for all BCTs was found to be above the midpoint (mean 7.61/10 [SD 1.38]). CONCLUSIONS A library of brief messages acceptable to people with type 2 diabetes and representative of specific evidence-derived BCTs was developed. This approach allowed brief messages to be developed with known content that can be used to test theory.

scholarly journals Biochemical Urine Testing of Medication Adherence and Its Association With Clinical Markers in an Outpatient Population of Type 2 Diabetes Patients: Analysis in the DIAbetes and LifEstyle Cohort Twente (DIALECT)

2021 ◽  
Author(s):  
Jelle M. Beernink ◽  
Milou M. Oosterwijk ◽  
Kamlesh Khunti ◽  
Pankaj Gupta ◽  
Prashanth Patel ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Real World ◽  
Ldl Cholesterol ◽  
Elevated Serum ◽  
Macrovascular Complications ◽  
Treatment Targets ◽  
Urine Testing ◽  
Diabetes Patients

Objective: To assess adherence to the three main drug classes in real-world patients with type 2 diabetes using biochemical urine testing and to determine the association of non-adherence with baseline demographics, treatment targets and complications. <p> </p> <p>Research Design and Methods: Analyses were performed in baseline data of 457 patients in the DIAbetes and LifEstyle Cohort Twente (DIALECT) study. Adherence to OADs (oral antidiabetics), antihypertensives and statins was determined by analyzing baseline urine samples using LC-MS/MS. Primary outcomes were micro/macrovascular complications and treatment targets of LDL-cholesterol, HbA1c and blood pressure. These were all assessed cross-sectionally at baseline.</p> <p> </p> <p>Results: Overall, 89.3% of the patients were identified as being adherent. Adherence rates to OADs, antihypertensives and statins were 95.7%, 92.0%, and 95.5%, respectively. The prevalence of microvascular (81.6% vs 66.2%, p = 0.029) and macrovascular complications (55.1% versus 37.0%, p = 0.014) was significantly higher in non-adherent patients. The percentage of patients who reached an LDL-cholesterol target of £2.5 mmol/L was lower (67.4% versus 81.1%, p = 0.029) in non-adherent patients. Binary logistic regression indicated that a higher BMI, current smoking, elevated serum LDL-cholesterol, high HbA1c, the presence of diabetic kidney disease and the presence of macrovascular disease were associated with non-adherence.</p> <p> </p> Conclusion: Despite medication adherence of real-world type 2 diabetes patients managed in specialist care was relatively high, the prevalence of microvascular and macrovascular complications was significantly higher in non-adherent patients and treatment targets were reached less frequently. This emphasizes the importance of objective detection and tailored interventions to improve non-adherence.

Perspectives and Views of Primary Care Professionals regarding a mHealth Intervention to Support Adherence to antidiabetic medication in People with Type 2 Diabetes in Spain: A Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Rocío Zamanillo-Campos ◽  
Maria Jesús Serrano-Ripoll ◽  
Joana Maria Taltavull-Aparicio ◽  
Elena Gervilla-García ◽  
Joana Ripoll-Amengual ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cost Effectiveness ◽  
Medication Adherence ◽  
Text Messaging ◽  
Text Messages ◽  
Antidiabetic Medication ◽  
Design And Implementation ◽  
Primary Care Professionals

BACKGROUND Type 2 Diabetes (T2D) is a long-term condition affecting 9.3% of people worldwide. People with T2D are at high risk of developing serious complications (e.g., blindness, lower-limb amputations, kidney disease, cardiovascular disease), which reduce their quality of life and life expectancy. Antidiabetic medication, if taken appropriately, is effective in preventing diabetes-related complications. However, 40% of T2D patients do not adequately adhere to their medication regimes. Brief text messages (e.g., SMS) delivered at a wide-scale and low cost via digital health systems represent a promising approach to support medication adherence. However, the views and perspectives of primary care professionals (PCP) regarding this type of intervention have seldom been explored. OBJECTIVE To explore PCPs’ views and perspectives concerning the DiabeText intervention, a new text messaging intervention currently being developed to support medication adherence in people with T2D in Mallorca (Spain). METHODS In this qualitative study, we conducted four focus groups (n=28) and eight semi-structured interviews with a purposive sample of primary care doctors and nurses with previous experience in the provision of healthcare to patients with T2D. Data collection explored the acceptability and usefulness of the DiabeText intervention and the barriers and facilitators to its development and implementation. Data analysis was carried out by researchers independently and discussed in a series of six meetings and a workshop. All data were coded by the lead author following an iterative approach. Initial notes were made, followed by a process of categorization and theme development following Braun and Clark’s methodology. RESULTS Three main themes were identified: 1) text messaging interventions have the potential to effectively support diabetes self-management (DSM); 2) Involving PCP in the intervention would facilitate its design and implementation, and; 3) obtaining evidence supporting the cost-effectiveness is a key prerequisite for large scale implementation of the intervention. PCPs drew on their knowledge and experience treating T2D patients to identify facilitators and barriers for the design and implementation of the intervention. They also made suggestions about the content and format of the text messages. PCPs identified additional areas (diet, exercise, diabetes complications, appointment reminders) that the messaging intervention should address to further support adequate DSM. CONCLUSIONS The DiabeText intervention is perceived as useful and acceptable by PCPs provided its cost-effectiveness. Involving PCPs in the design and implementation of the intervention is a key factor to optimize the potential impact of the proposed intervention.

scholarly journals Use of Brief Messages Based on Behavior Change Techniques to Encourage Medication Adherence in People With Type 2 Diabetes: Developmental Studies

10.2196/15989 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e15989
Author(s):  
Yvonne Kiera Bartlett ◽  
Andrew Farmer ◽  
Rustam Rea ◽  
David P French
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Behavior Change ◽  
Health Care Professionals ◽  
Text Messages ◽  
Test Theory ◽  
Behavior Change Techniques ◽  
Adherence To Medication ◽  
Adherence Support

Background Brief messages are a promising way to improve adherence to medication for people with type 2 diabetes. However, it is often unclear how messages have been developed and their precise content, making it difficult to ascertain why certain messages are successful and some are not. Objective The goal of the research was to develop messages that have proven fidelity to specified evidence-derived behavior change techniques (BCTs) and are acceptable to people with type 2 diabetes. Methods Four studies were conducted: (1) a workshop (n=21) where behavioral change researchers and health care professionals developed messages based on specific BCTs or beliefs or concerns related to taking medication, (2) a focus group study with people with type 2 diabetes (n=23) to assess acceptability of the approach, (3) a survey to ascertain the acceptability of a subset of messages to people with type 2 diabetes (n=61) and, (4) a survey with behavior change researchers to assess the fidelity of a subset of messages to their intended BCT (n=18). Results In study 1, 371 messages based on 38 BCTs and beliefs/concerns were developed. Workshop participants rated BCTs to be relevant to medication adherence (mean 7.12/10 [SD 1.55]) and messages to have good fidelity (mean 7.42/10 [SD 1.19]). In study 2, the approach of providing medication adherence support through text messages was found to be acceptable. In study 3, mean acceptability of all BCTs was found to be above the midpoint (mean 3.49/5 [SD 0.26]). In study 4, mean fidelity for all BCTs was found to be above the midpoint (mean 7.61/10 [SD 1.38]). Conclusions A library of brief messages acceptable to people with type 2 diabetes and representative of specific evidence-derived BCTs was developed. This approach allowed brief messages to be developed with known content that can be used to test theory.

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