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Contemp Clin Trials. 2019 Aug;83:46-52. doi: 10.1016/j.cct.2019.06.016. Epub 2019 Jun 28.

Rationale and design of the regimen education and messaging in diabetes (REMinD) trial.

Author information

1
Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America. Electronic address: r-oconor@northwestern.edu.
2
Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
3
Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
4
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
5
Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States of America.
6
Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, United States of America.

Abstract

BACKGROUND:

Individuals with type 2 diabetes manage complex multi-drug regimens, but nearly half of all patients do not consistently take the dose prescribed for them, and therefore may not receive the full potential therapeutic benefit. Both patient and health system factors contribute to achieving and maintaining medication adherence. To determine if patients with type 2 diabetes who are concurrently managing other chronic conditions could improve their adherence, we devised and are testing a multifaceted, primary care-based strategy to provide health literacy-appropriate and language concordant regimen information, guidance and reminders.

OBJECTIVE:

We are testing the effectiveness of an electronic health record (EHR) based strategy and short message service (SMS) text reminders to help patients with type 2 diabetes adhere to their medications.

METHODS:

We are conducting a 3-arm, multi-site trial to test and compare the effectiveness of the EHR, and EHR + SMS text reminder strategies compared to usual care on medication adherence. Our goal is to enroll a total of 900 English or Spanish-speaking patients with type 2 diabetes and hemoglobin A1C value ≥7.5%. Enrolled participants will complete interviews at baseline and 3 and 6 months following their baseline interview.

CONCLUSIONS:

Our trial is evaluating practical, clinic-based, scalable, evidence-based solutions for patients with type 2 diabetes managing complex medication regimens. Our findings will evaluate strategies that can be implemented broadly in primary care practices, and programmed as defaults within EHRs to support appropriate medication adherence to allow the widespread implementation of those strategies.

KEYWORDS:

Diabetes; Electronic health record; Health literacy; Medication adherence; Primary care; Text messaging

PMID:
31260791
PMCID:
PMC6642855
[Available on 2020-08-01]
DOI:
10.1016/j.cct.2019.06.016

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