British South Asian Patients’ Perspectives on the Relevance and Acceptability of Mobile Health Text Messaging to Support Medication Adherence for Type 2 Diabetes: Qualitative Study (Preprint)

BACKGROUND The prevalence of type 2 diabetes (T2D) is greater in South Asian populations and health outcomes are poorer compared with other ethnic groups. British South Asians are up to six times more likely to have T2D than the general population, to develop the condition at a younger age, and to experience diabetes-related complications. Interventions to support people in managing their condition can potentially reduce debilitating complications. Evidence to support the use of digital devices in T2D management, including mobile phones, has shown positive impacts on glycemic control. There is increasing recognition that health interventions that are culturally adapted to the needs of specific groups are more likely to be relevant and acceptable, but evidence to support the effectiveness of adapted interventions is limited and inconclusive. OBJECTIVE This formative study aimed to explore the perceptions and views of British South Asian patients with T2D on mobile health SMS text messaging to support medication adherence, aimed at the general UK population. METHODS Eight exploratory focus groups were conducted in Leicester, the United Kingdom, between September 2017 and March 2018. A diverse sample of 67 adults took part. RESULTS British South Asian people with T2D who use digital devices, including mobile phones, felt that short messages to support medication adherence would be acceptable and relevant, but they also wanted messages that would support other aspects of self-management too. Participants were particularly interested in content that met their information needs, including information about South Asian foods, commonly used herbs and spices, natural and herbal approaches used in the United Kingdom and in South Asia, and religious fasting. Short messages delivered in English were perceived to be acceptable, often because family members could translate for those unable to read or understand the messages. Suggestions to support patients unable to understand short messages in English included having them available in different formats, and disseminated in face-to-face groups for those who did not use digital devices. CONCLUSIONS Exploring the views of British South Asian patients about SMS text messaging aimed at the general UK population is important in maximizing the potential of such an intervention. For such a digital system to meet the needs of UK South Asian populations, it may also have to include culturally relevant messages sent to those who opt to receive them. It is equally important to consider how to disseminate message content to patients who do not use digital devices to help reduce health inequalities.

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British South Asian Patients’ Perspectives on the Relevance and Acceptability of Mobile Health Text Messaging to Support Medication Adherence for Type 2 Diabetes: Qualitative Study

JMIR mhealth and uhealth ◽

10.2196/15789 ◽

2020 ◽

Vol 8 (4) ◽

pp. e15789 ◽

Cited By ~ 4

Author(s):

Suman Prinjha ◽

Ignacio Ricci-Cabello ◽

Nikki Newhouse ◽

Andrew Farmer

Keyword(s):

Medication Adherence ◽

South Asian ◽

Mobile Phones ◽

Text Messaging ◽

Digital Devices ◽

Asian Populations ◽

Asian Patients ◽

The United Kingdom ◽

Short Messages

Background The prevalence of type 2 diabetes (T2D) is greater in South Asian populations and health outcomes are poorer compared with other ethnic groups. British South Asians are up to six times more likely to have T2D than the general population, to develop the condition at a younger age, and to experience diabetes-related complications. Interventions to support people in managing their condition can potentially reduce debilitating complications. Evidence to support the use of digital devices in T2D management, including mobile phones, has shown positive impacts on glycemic control. There is increasing recognition that health interventions that are culturally adapted to the needs of specific groups are more likely to be relevant and acceptable, but evidence to support the effectiveness of adapted interventions is limited and inconclusive. Objective This formative study aimed to explore the perceptions and views of British South Asian patients with T2D on mobile health SMS text messaging to support medication adherence, aimed at the general UK population. Methods Eight exploratory focus groups were conducted in Leicester, the United Kingdom, between September 2017 and March 2018. A diverse sample of 67 adults took part. Results British South Asian people with T2D who use digital devices, including mobile phones, felt that short messages to support medication adherence would be acceptable and relevant, but they also wanted messages that would support other aspects of self-management too. Participants were particularly interested in content that met their information needs, including information about South Asian foods, commonly used herbs and spices, natural and herbal approaches used in the United Kingdom and in South Asia, and religious fasting. Short messages delivered in English were perceived to be acceptable, often because family members could translate for those unable to read or understand the messages. Suggestions to support patients unable to understand short messages in English included having them available in different formats, and disseminated in face-to-face groups for those who did not use digital devices. Conclusions Exploring the views of British South Asian patients about SMS text messaging aimed at the general UK population is important in maximizing the potential of such an intervention. For such a digital system to meet the needs of UK South Asian populations, it may also have to include culturally relevant messages sent to those who opt to receive them. It is equally important to consider how to disseminate message content to patients who do not use digital devices to help reduce health inequalities.

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Developing a realist informed framework for cultural adaptation of lifestyle interventions for the prevention of type 2 diabetes in South Asian populations in Europe

Diabetic Medicine ◽

10.1111/dme.14584 ◽

2021 ◽

Author(s):

Emma M Davidson ◽

Marta Krasuska ◽

Anne Karen Jenum ◽

Jason M.R. Gill ◽

Erik Beune ◽

...

Keyword(s):

Type 2 Diabetes ◽

South Asian ◽

Cultural Adaptation ◽

Lifestyle Interventions ◽

Asian Populations

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ADHERENCE LEVEL AND BLOOD SUGAR CONTROL OF TYPE 2 DIABETES MELLITUS PATIENTS WHO GETS COUNSELING AND SHORT MESSAGES SERVICE AS REMINDER AND MOTIVATION

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i2.22988 ◽

2018 ◽

Vol 11 (2) ◽

pp. 219 ◽

Cited By ~ 3

Author(s):

Wirawan Adikusuma ◽

Nurul Qiyaam

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Medication Adherence ◽

Treatment Adherence ◽

Data Retrieval ◽

Control Group ◽

Hba1c Levels ◽

Short Messages

Objective: Examines the effects of counseling and short messages service (SMS) as a reminder and motivation toward medication adherence improvement and controlled HbA1c levels of type 2 diabetes mellitus (T2DM) patients.Methods: This study used a quasi-experimental method with prospective data retrieval. The subjects of this study were 40 patients with outpatient T2DM in internal disease polyclinic in West Nusa Tenggara Hospital, Indonesia. Patients who fulfilled the inclusion criteria were divided into two groups: The control group (n=20) receiving only the drug care service and the treatment group (n=20) receiving counseling and SMS reminder and motivation from the pharmacist. Data collecting was conducted using the pill count method, and HbA1c levels were taken from the medical record.Results: The results showed that counseling and SMS as reminder and motivation by a pharmacist can improve treatment adherence significantly (p<0.05) by 11.33 ± 8.47 and can decrease HbA1c level significantly (p<0.05) of 1.32 ± 0.72 in the intervention group. There was a positive correlation between T2DM patient treatment adherence to HbA1c levels (r=0.254, p=0.023).Conclusion: The provision of counseling and SMS as a reminder and motivation by the pharmacist can have a positive effect toward medication adherence and control of HbA1c in T2DM patients.

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Effects of a tailored text messaging intervention among diverse adults with type 2 diabetes: Evidence from the 15-month REACH RCT

10.2337/figshare.13052981.v1 ◽

2020 ◽

Author(s):

Lyndsay A. Nelson ◽

Robert A. Greevy ◽

Andrew Spieker ◽

Kenneth A. Wallston ◽

Tom A. Elasy ◽

...

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

Self Efficacy ◽

Text Messaging ◽

Self Care ◽

Baseline Hba1c ◽

Median Response ◽

Text Messaging Intervention

Objective: Text messaging interventions have high potential for scalability and to reduce health disparities; however, more rigorous, long-term trials are needed. We examined the long-term efficacy and mechanisms of a tailored text messaging intervention. Research Design and Methods: Adults with type 2 diabetes participated in a parallel-groups, 15-month randomized trial, assigned to receive REACH (Rapid Education/Encouragement and Communications for Health) for 12 months or control. REACH included interactive texts and tailored texts addressing medication adherence, and non-tailored texts supporting other self-care behaviors. Outcomes included HbA1c, diabetes medication adherence, self-care, and self-efficacy. Results: Participants (N=506) were approximately half racial/ethnic minority and half were underinsured, had annual household incomes <$35,000 USD and ≤ high school education; 11% were homeless. <a>Average baseline HbA1c was 8.6%±1.8%; 70.0±19.7 mmol/mol) with n=219 having HbA1c≥8.5% (69 mmol/mol)</a> and half were prescribed insulin. Retention was over 90%. Median response rate to interactive texts was 91% (interquartile range 75%, 97%). The treatment effect on HbA1c at 6 months (-0.31%; 95% CI [-0.61%, -0.02%]) was greater among those with baseline HbA1c≥8.5% (-0.74%; 95% CI [-1.26%, -0.23%]), and there was not evidence of effect modification by race/ethnicity or socioeconomic disadvantage. REACH improved medication adherence and diet through 12 months, and self-efficacy through 6 months. Treatment effects were not significant for any outcome at 15 months. REACH reduced barriers to adherence, but barrier reduction did not mediate outcome improvements. Conclusions: REACH engaged at-risk patients in diabetes self-management and improved short-term HbA1c. More than texts alone may be needed to sustain effects.

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Diabetes in South Asians

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.1401 ◽

2011 ◽

pp. 1799-1803

Author(s):

A. Ramachandran ◽

C. Snehalatha

Keyword(s):

South Asian ◽

Indian Subcontinent ◽

South Asians ◽

Stress Factors ◽

Rapid Urbanization ◽

Asian Populations ◽

Adults And Children ◽

Diabetic Population

Developing countries, mainly in the Indian subcontinent and China, contribute nearly 80% to the rising global diabetic population. Conservative estimates, based on population growth, ageing of population, and rate of urbanization in Asia, show that India and China will remain the top two countries with the highest number of people with diabetes by 2025: 71 and 38 million, respectively. Two other South Asian countries, Pakistan and Bangladesh, also are in the top ten list. The South Asian populations of Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka are racially heterogeneous, but all have high risk for diabetes and cardiovascular diseases. Type 1 diabetes is relatively less common, and nearly 95% of all diabetic cases in these regions are type 2 diabetes. The steady rise in the prevalence of diabetes seen in last three decades coincides with rapid urbanization and industrialization, and associated sociological and political changes, occurring in these countries (1). Among the populations, physical activity has reduced significantly, intake of energy-dense food has increased, and mental and physical stress factors associated with urban living have also increased. A tilt in the energy balance towards conservation and fat deposition has contributed to the alarming increase in the rate of obesity, both in adults and children.

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Prevalence and risk factors of renal artery stenosis in South Asian patients with type 2 diabetes using renal angiography

Indian Journal of Nephrology ◽

10.4103/0971-4065.125143 ◽

2014 ◽

Vol 24 (1) ◽

pp. 68

Author(s):

E Tan ◽

R Debajyoti ◽

S Sharma ◽

RD Bhatia ◽

S Barbier ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Renal Artery ◽

Renal Artery Stenosis ◽

South Asian ◽

Artery Stenosis ◽

Renal Angiography ◽

Asian Patients

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Adipocytokine Associations with Insulin Resistance in British South Asians

Journal of Diabetes Research ◽

10.1155/2013/561016 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

D. R. Webb ◽

K. Khunti ◽

S. Chatterjee ◽

J. Jarvis ◽

M. J. Davies

Keyword(s):

Metabolic Disease ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

South Asian ◽

South Asians ◽

Risk Groups ◽

Serum Samples ◽

Asian Populations ◽

Glucose Dysregulation

Aims. Adipocytokines are implicated in the pathogenesis of type 2 diabetes and may represent identifiable precursors of metabolic disease within high-risk groups. We investigated adiponectin, leptin, and TNF-αand assessed the contribution of these molecules to insulin resistance in south Asians.Hypothesis. South Asians have adverse adipocytokine profiles which associate with an HOMA-derived insulin resistance phenotype.Methods. We measured adipocytokine concentrations in south Asians with newly diagnosed impaired glucose tolerance or Type 2 Diabetes Mellitus in a case-control study. 158 (48.5% males) volunteers aged 25–75 years with risk factors for diabetes but no known vascular or metabolic disease provided serum samples for ELISA and bioplex assays.Results. Total adiponectin concentration progressively decreased across the glucose spectrum in both sexes. A reciprocal trend in leptin concentration was observed only in south Asian men. Adiponectin but not leptin independently associated with HOMA-derived insulin resistance after logistic multivariate regression.Conclusion. Diasporic south Asian populations have an adverse adipocytokine profile which deteriorates further with glucose dysregulation. Insulin resistance is inversely associated with adiponectin independent of BMI and waist circumference in south Asians, implying that adipocytokine interplay contributes to the pathogenesis of metabolic disease in this group.

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