Integration of Provider, Pharmacy, and Patient-Reported Data to Improve Medication Adherence for Type 2 Diabetes: A Controlled Before-After Pilot Study

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.

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Sleep Tracking and Exercise in Patients With Type 2 Diabetes Mellitus (Step-D): Pilot Study to Determine Correlations Between Fitbit Data and Patient-Reported Outcomes (Preprint)

10.2196/preprints.8122 ◽

2017 ◽

Author(s):

James Weatherall ◽

Yurek Paprocki ◽

Theresa M Meyer ◽

Ian Kudel ◽

Edward A Witt

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Pilot Study ◽

Patient Reported Outcomes ◽

Sleep Problems ◽

Health Data ◽

Patient Reported

BACKGROUND Few studies assessing the correlation between patient-reported outcomes and patient-generated health data from wearable devices exist. OBJECTIVE The aim of this study was to determine the direction and magnitude of associations between patient-generated health data (from the Fitbit Charge HR) and patient-reported outcomes for sleep patterns and physical activity in patients with type 2 diabetes mellitus (T2DM). METHODS This was a pilot study conducted with adults diagnosed with T2DM (n=86). All participants wore a Fitbit Charge HR for 14 consecutive days and completed internet-based surveys at 3 time points: day 1, day 7, and day 14. Patient-generated health data included minutes asleep and number of steps taken. Questionnaires assessed the number of days of exercise and nights of sleep problems per week. Means and SDs were calculated for all data, and Pearson correlations were used to examine associations between patient-reported outcomes and patient-generated health data. All respondents provided informed consent before participating. RESULTS The participants were predominantly middle-aged (mean 54.3, SD 13.3 years), white (80/86, 93%), and female (50/86, 58%). Use of oral T2DM medication correlated with the number of mean steps taken (r=.35, P=.001), whereas being unaware of the glycated hemoglobin level correlated with the number of minutes asleep (r=−.24, P=.04). On the basis of the Fitbit data, participants walked an average of 4955 steps and slept 6.7 hours per day. They self-reported an average of 2.0 days of exercise and 2.3 nights of sleep problems per week. The association between the number of days exercised and steps walked was strong (r=.60, P<.001), whereas the association between the number of troubled sleep nights and minutes asleep was weaker (r=.28, P=.02). CONCLUSIONS Fitbit and patient-reported data were positively associated for physical activity as well as sleep, with the former more strongly correlated than the latter. As extensive patient monitoring can guide clinical decisions regarding T2DM therapy, passive, objective data collection through wearables could potentially enhance patient care, resulting in better patient-reported outcomes.

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

Journal of Diabetes Science and Technology ◽

10.1177/19322968211060060 ◽

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.

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Imagine to Remember: An Episodic Future Thinking Intervention to Improve Medication Adherence in Patients with Type 2 Diabetes

Patient Preference and Adherence ◽

10.2147/ppa.s342118 ◽

2022 ◽

Vol Volume 16 ◽

pp. 95-104

Author(s):

Leonard H Epstein ◽

Tatiana Jimenez-Knight ◽

Anna M Honan ◽

Rocco A Paluch ◽

Warren K Bickel

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

Episodic Future Thinking ◽

Future Thinking ◽

Improve Medication Adherence

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Preliminary engagement of a patient advisory board of African American community members with type 2 diabetes in a peer-led medication adherence intervention

Research Involvement and Engagement ◽

10.1186/s40900-020-00245-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Olayinka O. Shiyanbola ◽

Betty L. Kaiser ◽

Gay R. Thomas ◽

Adati Tarfa

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

African Americans ◽

Main Body ◽

Improve Medication Adherence ◽

Intervention Delivery ◽

Culturally Tailored ◽

Negative Beliefs ◽

Adherence Intervention

Abstract Background The Peers Supporting Health Literacy, Self-efficacy, Self-Advocacy, and Adherence (Peers LEAD) program is a culturally tailored educational-behavioral 8-week intervention that addressed psychosocial and sociocultural barriers to diabetes medication adherence in African Americans. A brief 3-week version of the Peers LEAD intervention used a community engagement approach to examine the feasibility and acceptability of the intervention amongst patient stakeholders. Main body African Americans who were adherent to their diabetes medicines were paired with those who were non-adherent to their medicines. Together, they participated in the group and phone-based medication adherence intervention. Input from this brief intervention was important for the design of the remainder weeks of the 8-week program. The intervention targeted negative beliefs about diabetes, use of diabetes medicines, and offering culturally tailored peer support to improve medication adherence in African Americans. To receive input in the development and implementation of the program, we worked with community advisors and a peer ambassador board of African Americans who were adherent to their diabetes medicines. The peer ambassador board and community advisors reviewed intervention materials to ensure they were understandable and appropriate for the community. As well, they provided feedback on the process for intervention delivery. Conclusion The active engagement of the peer ambassador board and community advisors led to a revised intervention process and materials for a medication adherence program for African Americans with type 2 diabetes.

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Psychometric properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: systematic review protocol

Systematic Reviews ◽

10.1186/s13643-021-01755-w ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Henrique Ceretta Oliveira ◽

Daisuke Hayashi Neto ◽

Samantha Dalbosco Lins Carvalho ◽

Rita de Cássia Lopes Barros ◽

Mayza Luzia dos Santos Neves ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Medication Adherence ◽

Cardiovascular Diseases ◽

Measurement Properties ◽

Health Measurement ◽

Patient Reported

Abstract Background The pharmacological treatment of cardiovascular diseases and type 2 diabetes mellitus reduces the risk of cardiovascular events.; however, most patients do not adhere to the treatment. There are several self-reported measures for assessing medication adherence. Identifying the instruments with the best psychometric evidence is essential for selecting an accurate measure. The aim of this study is to critically assess, compare and synthesize the quality of the measurement properties of patient-reported outcome measures to access medication adherence among patients with cardiovascular diseases and/or type 2 diabetes mellitus. Methods This protocol is reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. The following databases will be searched: Web of Science, SCOPUS, PubMed, CINAHL, EMBASE, LILACS, PsycINFO and ProQuest. Discussion This review will provide a detailed assessment of the measurement properties of self-reported medication adherence instruments in patients with cardiovascular diseases and/or type 2 diabetes mellitus to support clinical practice and research. Systematic review registration PROSPERO CRD42019129109.

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Public Counseling: An Educational Model to Improve Medication Adherence in Type 2 Diabetes Mellitus Patients

Proceedings of the 1st Muhammadiyah International Conference on Health and Pharmaceutical Development ◽

10.5220/0008239600710076 ◽

2018 ◽

Author(s):

Daniek Viviandhari ◽

Nora Wulandari ◽

Francyska Putri Puspita

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Medication Adherence ◽

Educational Model ◽

Improve Medication Adherence

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

10.2196/preprints.9735 ◽

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.

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Sleep Tracking and Exercise in Patients With Type 2 Diabetes Mellitus (Step-D): Pilot Study to Determine Correlations Between Fitbit Data and Patient-Reported Outcomes

JMIR mhealth and uhealth ◽

10.2196/mhealth.8122 ◽

2018 ◽

Vol 6 (6) ◽

pp. e131 ◽

Cited By ~ 11

Author(s):

James Weatherall ◽

Yurek Paprocki ◽

Theresa M Meyer ◽

Ian Kudel ◽

Edward A Witt

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Pilot Study ◽

Patient Reported Outcomes ◽

Patient Reported

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Effect of medication adherence on clinical outcomes in type 2 diabetes: analysis of the SIMPLE study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000761 ◽

2019 ◽

Vol 7 (1) ◽

pp. e000761 ◽

Cited By ~ 2

Author(s):

Sapna Patel ◽

Marconi Abreu ◽

Anna Tumyan ◽

Beverley Adams-Huet ◽

Xilong Li ◽

...

Keyword(s):

Quality Of Life ◽

Type 2 Diabetes ◽

Medication Adherence ◽

Basal Insulin ◽

Adherence Rate ◽

Patient Reported ◽

Bolus Insulin

ObjectiveMedication adherence is impacted by regimen complexity. The SIMPLE (Simple basal Insulin titration, Metformin Plus Liraglutide for type 2 diabetes with very Elevated HbA1c) study compared GLP1RA plus basal insulin (GLP1RA+BI) to basal-bolus insulin (BBI) regimen in participants with very uncontrolled type 2 diabetes mellitus (T2DM). This analysis aimed to evaluate medication adherence to GLP1RA+BI compared with BBI, the effect of adherence on clinical and patient-reported outcomes, and baseline predictors of adherence.Research design and methodsThis was an analysis of the SIMPLE study based on prespecified outcome. The study took place in pragmatic, real-world setting. A total of 120 adults with T2DM and HgbA1c≥10% were randomized to detemir plus liraglutide, or detemir plus aspart before each meal; 6-month follow-up. The main outcomes evaluated were: adherence, HgbA1c, weight, quality of life, and hypoglycemia. Adherence rate was calculated for each study medication at each follow-up visit; participants were classified as ≥80% or <80% adherent.ResultA higher percentage of participants in the GLP1RA+BI compared with the BBI group had ≥80% adherence to detemir (59.3% vs 35.7%, p=0.02) as well as liraglutide versus aspart (57.4% vs 30.4%, p=0.007). Higher age was predictive of ≥80% adherence (OR per 5-year increment=1.48, 95% CI 1.09 to 2.0, p=0.01). Higher adherence led to greater improvement in HbA1c and weight in both groups. Treatment with GLP1RA+BI compared with BBI led to greater improvement in HbA1c, weight, and quality of life and lower risk of hypoglycemia even after adjusting for the difference in adherence between groups.ConclusionsAdherence was higher with the simplified regimen of GLP1RA+BI compared with BBI. Greater adherence to the simpler regimen amplified the treatment effect on HbA1c, weight, quality of life, and risk of hypoglycemia, yet statistically significant greater benefits were noted even when adjusted for adherence.Trial registration numberNCT01966978

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