Nelson Lyndsay A, Mulvaney Shelagh A, Gebretsadik Tebeb, Johnson Kevin B, Osborn Chandra Y
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA.
J Behav Med. 2016 Dec;39(6):995-1000. doi: 10.1007/s10865-016-9774-2. Epub 2016 Aug 3.
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.
患有2型糖尿病（T2DM）且社会经济地位（SES）较低的成年人药物治疗依从性较差，进而血糖控制不佳（糖化血红蛋白[HbA1c]）。我们测试了短信服务（SMS）文本信息和交互式语音应答（IVR）干预措施对促进这一高危群体依从性的初始效果。80名社会经济地位较低、患有T2DM的成年人使用了糖尿病信息（MED）短信/IVR干预措施，为期3个月。我们采用前后单组设计来探究3个月内依从性的变化，并采用准实验设计来测试MED相对于匹配的存档对照组对干预组HbA1c的影响。与基线相比，1个月时（调整后比值比[AOR] 3.88，95%置信区间[CI] 1.79，10.86）和2个月时（AOR 3.76，95% CI 1.75，17.44）依从性有所改善，但3个月时没有改善。HbA1c保持稳定，干预组和对照组在3个月时没有差异。MED对依从性有积极的短期影响，但并未转化为HbA1c的改善。未来的研究应探索短信/IVR干预措施对患有T2DM的高危成年人药物治疗依从性的长期影响。
