The MEssaging for Diabetes Intervention Reduced Barriers to Medication Adherence among Low-Income, Diverse Adults with Type 2

Abstract

Background: Nonadherence to diabetes medication is prevalent and costly. MEssaging for Diabetes (MED), a mobile health (mHealth) intervention, identified and addressed user-specific barriers to medication adherence. We assessed whether MED reduced users' targeted barriers and if barrier reductions were associated with within-participant improvements in adherence or glycemic control (HbA1c). Methods: Adults (N = 80) with type 2 diabetes completed self-report measures identifying barriers to adherence at baseline and monthly for 3 months. At each assessment, 17 barriers were assessed and ranked for each user. Each subsequent month, users received daily text messages addressing their 3 highest ranked barriers. Targeted barriers were different for each participant and could change monthly. Paired t-tests assessed within-participant improvement in targeted barriers each month, and nested regression models assessed if changes in a participant's barrier scores were associated with improvements in adherence and HbA1c. Results: Participants were 69% non-white and 82% had incomes