mobile health intervention for improved adherence in type 2 diabetes

Conditions: Diabetes Mellitus

Summary: the study assessed patients' glycemic control, knowledge of type 2 diabetes (t2d) and adherence to medications, and evaluated the impact of a mobile telephone-based intervention on these indices. patients' clinic attendance and pharmacy refill records were reviewed for the period of 1 year. then over a period of 1 month, newly diagnosed t2d patients were enrolled in the prospective phase of the study and randomized into control and intervention groups. a mobile phone-based health education and follow-up package was applied to the intervention group alone for a period of 6 months. afterwards, both groups were assessed and compared on the study outcome parameters. same questionnaires were used pre- and post-intervention for primary data collection. descriptive and inferential statistics were used for data analysis.

objectives of the study: the study assessed patients' glycemic control, knowledge of type 2 diabetes (t2d) and adherence to medications, and evaluated the impact of a mobile telephone-based intervention on these indices. study design: randomized controlled trial study setting: diabetes clinic, endocrinology unit, department of internal medicine, obafemi awolowo university teaching hospital ile ife, osun state nigeria the study was structured in five stages. study duration: seven months stage 1: baseline data task 1: baseline data for patients' glycemic control were obtained from one-year retrospective review of 1392 patients' files for glycated haemoglobin (hba1c) measurements. task 2: patients' baseline adherence data were obtained from one-year retrospective review of pharmacy refill records (clinic attendance) task 3: development and validation of research instruments (questionnaires, short message services (sms). task 4: recruitment and training of research assistants (2 hours daily for 3 days) stage 2: recruitment and randomization of participants task 1: enrolment of all newly-diagnosed patients (n = 120), enrolled in the diabetes clinic in the period of one month following stage 1 task 2: obtaining of informed consent from all newly-diagnosed patients enrolled in the diabetes clinic in the one month following stage 1 task 3: collection of participants' baseline knowledge data using structured questionnaire task 4: collection of baseline self-reported adherence data using the adapted 8-point morisky medication adherence scale (mmas-8) instrument task 5: randomization of consenting participants into two equal (n = 60) control and intervention groups using a randomization software stage 3: intervention task 1: activation of short message services to participants in the intervention cohort at a frequency of one message per day for the period of 6 months. task 2: follow up on clinic attendances of all participants for the period of 6 months stage 4: post-intervention review task 1: repeat administration of same questionnaires originally administered at stage 2 to all participants task 1: review of participants' clinic attendance and pharmacy refill records task 2: review of participants hba1c measurements from their records stage 5: data analysis task 1: demographic variables of participants were analyzed using descriptive statistics including frequency and percentages task 2: weighted mean scores were used to analyze knowledge and adherence scores task 3: two-sample t-test was used to compare pre- and post-intervention scores of knowledge and adherence task 4: chi square test was conducted to analyze associations between demographic variables and self-reported adherence data task 5: statistical package for the social sciences (spss) version 21 for windows software was used for data analysis at the p \< 0.05 level of significance

Eligibility criteria:
inclusion criteria: * diagnosed of type 2 diabetes for the first time in the month following baseline study * male or female, 18 yeas of age and above * enrolled in the out-patient diabetes clinic of the teaching hospital * gave informed consent to participate. exclusion criteria: * diagnosed of other disease conditions outside type 2 diabetes * below 18 years of age * not enrolled in the out-patient diabetes clinic of the teaching hospital * did not give informed consent

Keywords: mobile health type 2 diabetes adherence health education follow-up