Mobile App Interventions to Improve Medication Adherence Among Type 2 Diabetes Mellitus Patients: A Systematic Review of Clinical Trials

2021 ◽  
pp. 193229682110600
Author(s):  
Tarani Prakash Shrivastava ◽  
Shikha Goswami ◽  
Rahul Gupta ◽  
Ramesh K. Goyal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Mobile Apps ◽  
Mobile App ◽  
Risk Of Bias ◽  
Improve Medication Adherence

Background: Medication adherence in type 2 diabetes mellitus (T2DM) patients is often suboptimal resulting in complications. There has been a growing interest in using mobile apps for improving medication adherence. Objective: The objective of this work was to systematically review the clinical trials that have used mobile app–based interventions in T2DM patients for improving medication adherence. Methodology: A systematic search was performed to identify published clinical trials between January 2008 and December 2020 in databases—PubMed, Cochrane Library, and Google Scholar. All studies were assessed for risk of bias using quality rating tool from the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seven clinical studies having 649 participants were studied. The median sample size was 58 (range = 41-247) and the median age of participants was 53.2 (range = 48-69.4) years. All studies showed improvements in adherence; however, only three studies reported statically significant improvements in adherence measures. Selected studies were deemed as unclear in their risk of bias and the most common source of risk of bias among the studies was the absence of objective outcome assessment. Conclusions: Mobile apps appear to be effective interventions to help improve medication adherence in T2DM patients compared with conventional care strategies. The features of the App to improvise medical adherence cannot be defined based on the meta-analysis because of heterogeneity of study designs and less number of sample size. Systematically planned studies would set up applicability of mobile apps in the clinical management of T2DM.

scholarly journals Medication Adherence Analysis of Type 2 Diabetes Mellitus Patients

2019 ◽  
Vol 1 (3) ◽  
pp. 107
Author(s):  
Sulistyo Andarmoyo ◽  
Harmy Bin Mohamed Yusoff ◽  
Berhanudin Bin Abdullah ◽  
Yuzana Binti Mohd Yusop
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Sex Education ◽  
Service Management ◽  
Health Care Facilities ◽  
Improve Medication Adherence ◽  
Cross Sectional

Adherence has an important role in therapy management in patients with type 2 Diabetes Mellitus. This research is to identify and analyze factors related to medication adherence. The design used in this study was a descriptive-analytic design with a cross-sectional approach. The population is type 2 Diabetes Mellitus sufferers of Prolanis Group in Primary Health Care Facilities in the Ponorogo Regency. A sample of 180 respondents was taken by purposive sampling technique. Variable X includes age, gender, education, occupation, income, and length of suffering. Variable Y was medication compliance with type 2 Diabetes Mellitus patients. Data collection used a Morisky Medication Adherence (MMAS-8) questionnaire and was analyzed using the Chi-Square test with a significant level of α <0.05. From the results of the study, it was found that the factors of age, sex, education, employment, income and duration of suffering had a significant relationship with medication adherence for patients with type 2 diabetes mellitus. It is expected that health services develop family and community-based service management. Researchers are further advised to develop programs to improve medication adherence.

scholarly journals Medication Adherence in Type 2 Diabetes Mellitus: A Qualitative Exploration of Barriers and Facilitators From Socioecological Perspectives

2021 ◽  
Vol 8 ◽  
pp. 237437352110343
Author(s):  
EE Onwuchuluba ◽  
OO Oyetunde ◽  
RO Soremekun
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Spousal Support ◽  
Tertiary Hospital ◽  
Clinic Visit ◽  
Barriers And Facilitators ◽  
Improve Medication Adherence

Adherence to antidiabetic medications (ADMs) remains a serious challenge among type 2 diabetes mellitus (T2DM) patients. Factors affecting medication adherence are not fully understood in Nigeria. This qualitative study explored patients’ views on barriers and facilitators of medication adherence. Data collection was through face-to-face, semistructured, in-depth interviews conducted on 25 purposively sampled patients attending a public tertiary hospital. The interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis based on socioecological framework. NVIVO version 10 identified more codes. Most commonly identified barriers were organizational (clinic structure), personal (perception of T2DM as a dangerous illness), interpersonal (lack of spousal support), and community (concerns about taking ADMs in social gatherings). It was observed that female patients received more spousal support than the males. The facilitators of adherence include perceiving medication-taking a routine, the need to live longer, having savings for ADMs, purchasing medications to last until the next clinic visit. This study identified barriers and facilitators unique to Nigerian T2DM patients. Interventions anchored on these factors would improve medication adherence.

scholarly journals MEDICATION ADHERENCE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS - A CROSS-SECTIONAL STUDY

2019 ◽  
pp. 177-180
Author(s):  
PRATHYUSHA RANI T ◽  
PRASHANTHI B ◽  
AYESHA AMREEN FATHIMA ◽  
AYESHA FIRDOSE ◽  
SARA NASER ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Drug Therapy ◽  
Medication Adherence ◽  
Diabetic Patients ◽  
Type Ii ◽  
Improve Medication Adherence ◽  
Cross Sectional

Objective: This study was conducted to determine the adherence of medications among type 2 diabetes mellitus (DM) patients. To evaluate adherence to therapy and study factors associated with non-adherence and adherence in patients with type II DM. Methods: A cross-sectional, observational study was conducted for 6 months in three hospitals. A total of 200 type II diabetic patients, who were on anti-diabetic drug therapy for at least 6 months, were enrolled. Blood glucose was measured and details of drug therapy were noted. Medication adherence was assessed using the Morisky Medication Adherence Scale and adherence scores were calculated. Results: Only 15% had high medication adherence, while 24% had moderate and 61% had low medication adherence. Only 30% were having optimally controlled glycemic levels, whereas 70% were having uncontrolled glycemic levels. Medication adherence scores were lower (reflecting lower adherence) in type II patients with uncontrolled glycemic levels than those having optimally controlled glycemic levels, but this difference was not statistically significant. Conclusion: Overall, medication adherence was low in type II diabetic patients. The study shows that to improve medication adherence, better counseling and health education of patients are required. Although several patients were adherent to therapy, adherent patients are more preferably to achieve glycemic control than nonadherent patients. Greater efforts are needed to facilitate diabetes self-management behaviors to improve patient outcomes.

scholarly journals Impact of DSMES app interventions on medication adherence in type 2 diabetes mellitus: systematic review and meta-analysis

2021 ◽  
Vol 28 (1) ◽  
pp. e100291
Author(s):  
Dumisani Enricho Nkhoma ◽  
Charles Jenya Soko ◽  
Kondwani Joseph Banda ◽  
David Greenfield ◽  
Yu-Chuan (Jack) Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Usual Care ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Moderate Risk

ObjectivesTo conduct systematic review and meta-analysis of interventional studies to investigate the impact of diabetes self-management education and support (DSMES) apps on adherence in patients with type 2 diabetes mellitus (T2D).MethodsPubMed, Embase, CENTRAL, Web of Science, Scopus and ProQuest were searched, in addition to references of identified articles and similar reviews. Experimental studies, reported in English, assessing DSMES app intervention’s impact on adherence and clinical outcomes of patients with T2D compared with usual care were included. Study bias was assessed using Cochrane Risk of Bias V.2.0 tool. Analysis plan involved narrative synthesis, moderator and meta-analysis.ResultsSix randomised controlled trials were included, involving 696 participants (average age 57.6 years, SD 10.59). Mobile apps were mostly used for imputing clinical data, dietary intake or physical activity, and transmitting information to the provider. At 3 months, DSMES apps proved effective in improving medication adherence (standardized mean difference (SMD)=0.393, 95% CI 0.17 to 0.61), glycated haemoglobin (HbA1c) (mean difference (MD)=−0.314, 95% CI −0.477 to –0.151) and Body Mass Index (BMI) (MD=−0.28, 95% CI −0.545 to –0.015). All pooled estimates had low heterogeneity (I2 0%). Four studies had moderate risk of bias while one each was judged to be low and high risks, respectively.ConclusionDSMES apps had significant small to moderate effects on medication adherence, HbA1c and BMI of patients with T2D compared with usual care. Apps were described as reliable, easy to use and convenient, though participants were required to be phone literate. Evidence comes from feasibility trials with generally moderate risk of bias. Larger trials with longer follow-up periods using theory-based interventions are required to improve current evidence.

scholarly journals Impact of timing of randomization after an acute coronary syndrome and subsequent events in patients with type 2 diabetes mellitus: an analysis of the EXAMINE trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Elharram ◽  
A Sharma ◽  
W White ◽  
G Bakris ◽  
P Rossignol ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Type 2 Diabetes Mellitus ◽  
Acute Coronary Syndrome ◽  
Primary Outcome ◽  
Funding Source ◽  
Coronary Syndrome ◽  
The Impact

Abstract Background The timing of enrolment following an acute coronary syndrome (ACS) may influence cardiovascular (CV) outcomes and potentially treatment effect in clinical trials. Using a large contemporary trial in patients with type 2 diabetes mellitus (T2DM) post-ACS, we examined the impact of timing of enrolment on subsequent CV outcomes. Methods EXAMINE was a randomized trial of alogliptin versus placebo in 5380 patients with T2DM and a recent ACS. The primary outcome was a composite of CV death, non-fatal myocardial infarction [MI], or non-fatal stroke. The median follow-up was 18 months. In this post hoc analysis, we examined the occurrence of subsequent CV events by timing of enrollment divided by tertiles of time from ACS to randomization: 8–34, 35–56, and 57–141 days. Results Patients randomized early (compared to the latest times) had less comorbidities at baseline including a history of heart failure (HF; 24.7% vs. 33.0%), prior coronary artery bypass graft (9.6% vs. 15.9%), or atrial fibrillation (5.9% vs. 9.4%). Despite the reduced comorbidity burden, the risk of the primary outcome was highest in patients randomized early compared to the latest time (adjusted hazard ratio [aHR] 1.47; 95% CI 1.21–1.74) (Figure 1). Similarly, patients randomized early had an increased risk of recurrent MI (aHR 1.51; 95% CI 1.17–1.96) and HF hospitalization (1.49; 95% CI 1.05–2.10). Conclusion In a contemporary cohort of T2DM with a recent ACS, early randomization following the ACS increases the risk of CV events including recurrent MI and HF hospitalization. This should be taken into account when designing future clinical trials. Figure 1 Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Takeda Pharmaceutical

Predictors of medication adherence in patients with type 2 diabetes mellitus

2013 ◽  
Vol 29 (10) ◽  
pp. 1275-1286 ◽  
Author(s):  
Suellen M. Curkendall ◽  
Nina Thomas ◽  
Kelly F. Bell ◽  
Paul L. Juneau ◽  
Audrey J. Weiss
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence
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