title: The MEssaging for Diabetes (MED) intervention improves short-term medication adherence among low-income adults with type 2 diabetes.
abstract: Adults with type 2 diabetes (T2DM) and low socioeconomic status (SES) have high rates of medication nonadherence, and, in turn, suboptimal glycemic control (hemoglobin A1c [HbA1c]). We tested the initial efficacy of a short message service (SMS) text messaging and interactive voice response (IVR) intervention to promote adherence among this high-risk group. Eighty low SES, diverse adults with T2DM used the MEssaging for Diabetes (MED) SMS/IVR intervention for 3 months. We used a pre-post single group design to explore adherence changes over 3 months, and a quasi-experimental design to test the impact of MED on HbA1c among the intervention group relative to a matched, archival control group. Compared to baseline, adherence improved at one (AOR 3.88, 95 % CI 1.79, 10.86) and at 2 months (AOR 3.76, 95 % CI 1.75, 17.44), but not at 3 months. HbA1c remained stable, with no differences at 3 months between the intervention group and the control group. MED had a positive, short-term impact on adherence, which did not translate to improvements in HbA1c. Future research should explore the longer-term impact of SMS/IVR interventions on the medication adherence of high risk adults with T2DM.
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.|Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Lyndsay A
authors.initials: LA
authors.lastname: Nelson
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, TN, USA.|Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA.|Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.|Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Shelagh A
authors.initials: SA
authors.lastname: Mulvaney
authors.affiliation: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.affiliation: Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Johnson
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. chandra.osborn@vanderbilt.edu.|Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA. chandra.osborn@vanderbilt.edu.|Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA. chandra.osborn@vanderbilt.edu.|Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA. chandra.osborn@vanderbilt.edu.
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012923:Social Class; D060145:Text Messaging
chemical_list: D006442:Glycated Hemoglobin
keywords: Behavioral interventions; Diabetes; Health promotion; Medication adherence; Mobile health; Vulnerable populations