The impact of tailored text messages on health beliefs and medication adherence in adults with diabetes: A randomized pilot study

Justin Gatwood, Rajesh Balkrishnan, Steven R. Erickson, Lawrence C. An, John D. Piette, Karen B. Farris

Research output: Contribution to journalArticle

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Abstract

Background: Inadequate medication adherence reduces optimal health outcomes and can lead to increased costs, particularly in patients with diabetes. Efforts to improve adherence have resulted in limited effects; approaches leveraging mobile technology have emerged, but their focus has mainly been limited to simple reminder messages. Objective: The purpose of this pilot study was to test the effectiveness of tailored text messages focusing on improving medication adherence and health beliefs in adults with diabetes. Methods: Adults aged 21-64, with uncontrolled diabetes, and taking at least one anti-diabetic medication were recruited and randomized into 2 study arms: daily tailored text messaging for 90 days or standard care. Comparing baseline and endpoint survey responses, changes in theory-driven health beliefs and attitudes were assessed. The impact on medication adherence was evaluated using pharmacy claims by calculating the percent of days covered (PDC). Results: A total of 75 subjects were consented, and 48 were randomized. Mean PDC at baseline were comparable between cohorts (84.4% and 87.1%, respectively). Declines in adherence were observed in both groups over time but no significant differences were observed between groups or from baseline to the end of the active study period. Unadjusted tests suggested that perceived benefits and competence might have improved in the intervention arm. Conclusions: Tailoring mobile phone text messages is a novel way to address medication nonadherence and health beliefs; further investigation to this combined technique is needed to better understand its impact on behavior change in adults with diabetes.

Original languageEnglish (US)
Pages (from-to)130-140
Number of pages11
JournalResearch in Social and Administrative Pharmacy
Volume12
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Text Messaging
Medication Adherence
Health
Jejunoileal Bypass
Aortic Valve Insufficiency
Attitude to Health
Cell Phones
Technology
Costs and Cost Analysis
Acyclic Acids
Sunstroke
Echoencephalography
Community Psychiatry
Acromegaly
Mobile phones
Costs

Keywords

  • Adherence
  • Behavioral theory
  • Mobile health
  • Self-management
  • Tailoring

ASJC Scopus subject areas

  • Pharmacy
  • Pharmaceutical Science

Cite this

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abstract = "Background: Inadequate medication adherence reduces optimal health outcomes and can lead to increased costs, particularly in patients with diabetes. Efforts to improve adherence have resulted in limited effects; approaches leveraging mobile technology have emerged, but their focus has mainly been limited to simple reminder messages. Objective: The purpose of this pilot study was to test the effectiveness of tailored text messages focusing on improving medication adherence and health beliefs in adults with diabetes. Methods: Adults aged 21-64, with uncontrolled diabetes, and taking at least one anti-diabetic medication were recruited and randomized into 2 study arms: daily tailored text messaging for 90 days or standard care. Comparing baseline and endpoint survey responses, changes in theory-driven health beliefs and attitudes were assessed. The impact on medication adherence was evaluated using pharmacy claims by calculating the percent of days covered (PDC). Results: A total of 75 subjects were consented, and 48 were randomized. Mean PDC at baseline were comparable between cohorts (84.4% and 87.1%, respectively). Declines in adherence were observed in both groups over time but no significant differences were observed between groups or from baseline to the end of the active study period. Unadjusted tests suggested that perceived benefits and competence might have improved in the intervention arm. Conclusions: Tailoring mobile phone text messages is a novel way to address medication nonadherence and health beliefs; further investigation to this combined technique is needed to better understand its impact on behavior change in adults with diabetes.",
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