Diabetes affects 422 million people worldwide, and the majority of these are affected by type 2 diabetes. People with type 2 diabetes are commonly prescribed oral antidiabetic medications. If taken as intended, these medications can be effective in lowering HbA1c (a measure of blood glucose concentration). However, people are often concerned about starting new medicines and face difficulties in taking them regularly, often termed nonadherence. Poorly controlled HbA1c can lead to numerous complications.
Current interventions to support medication taking both in diabetes and in other long-term conditions have had limited success, can be complex, difficult to access and the science and rationale upon which they are based are often poorly described. However, text messages have been identified as a promising tool in supporting medication adherence in type 2 diabetes.
We are funded by the National Institute for Health Research (NIHR) to conduct a series of interlinked work packages over the course of five years, in order to explore the development and evaluation of text messages to support medicine taking, grounded in principles of behaviour change. Formative work has included focus groups and individual interviews with patients, pilot studies of a functioning prototype to explore feasibility and acceptability, and qualitative work with primary care staff to explore the way the interventions might be integrated into usual care. We are currently about to begin recruitment for a multi-site randomised controlled trial in primary care, in which nearly 1000 people will be invited to participate and use the system for up to one year.
In addition, we have conducted extensive qualitative work with members of the British South Asian community to determine whether and how a brief messaging system might support them in managing their type 2 diabetes. Next steps include working closely with community members to co-design culturally appropriate content.
Bartlett, Y.K., Newhouse, N., Miles, L., Kenning, C., French, D., & Farmer, A. (under review). Understanding acceptability in the context of a text message intervention to encourage medication adherence in people with type 2 diabetes: A mixed methods study.
Bartlett, Y.K., French, D., Newhouse, N., Miles, L., Kenning, C., & Farmer, A. (under review). How does a text-messaging service to support medication adherence in people with type 2 diabetes work? An exploration of context and mechanisms.
Prinjha, S., Ricci-Cabello, I., Newhouse, N., & Farmer, A. British South Asian Patients’ Perspectives on the Relevance and Acceptability of Mobile Health Text Messaging to Support Medication Adherence for Type 2 Diabetes: Qualitative Study. JMIR Mhealth Uhealth 2020;8(4):e15789.
Farmer, A., Allen, J., Bartlett, Y.K., et al. Supporting people with type 2 diabetes in effective use of their medicine through mobile health technology integrated with clinical care (SuMMiT-D Feasibility): a randomised feasibility trial protocol. BMJ Open 2019;9:e033504.
Bartlett, Y.K., Newhouse, N., Long, H. A., Farmer, A. J., & French, D. P. (2019). What do people with type 2 diabetes want from a brief messaging system to support medication adherence?. Patient preference and adherence, 13, 1629–1640.