Aikaterini Kassavou|Venus Mirzaei|James Brimicombe|Simon Edwards|Efthalia Massou|A. Toby Prevost|Simon J. Griffin|Stephen Sutton
A Highly Tailored Text and Voice Messaging Intervention to Improve Medication Adherence in Patients With Either or Both Hypertension and Type 2 Diabetes in a UK Primary Care Setting: Feasibility Randomized Controlled Trial of Clinical Effectiveness
University of Cambridge|University of Cambridge|University of Cambridge|University of Cambridge|University of Cambridge|Imperial College London|University of Cambridge|University of Cambridge
background efficacy highly tailored digital intervention support medication adherence feasibility support clinical effectiveness adjunct primary care setting evaluated objective trial aimed assess behavioral efficacy highly tailored digital intervention support medication adherence evaluate feasibility clinical effectiveness patients either hypertension type 2 diabetes also examined quality life mechanisms behavior change intervention fidelity engagement satisfaction also explored methods multicenter individually randomized controlled trial 2 parallel groups intervention group received highly tailored text message interactive voice response intervention 12 weeks control group received usual care medication adherence measured using selfreports assessorblinded practice records repeat prescription systolic blood pressure glucose levels assessed nurses blinded group allocation practice visits 3 months followup questionnaires obtained data assess intervention mechanisms action satisfaction digital log files captured data evaluate fidelity engagement results total 135 nonadherent patients 62135 46 female 122135 903 aged 50 years randomly allocated intervention n79 control group n56 13 18135 lost followup medication adherence significantly improved intervention group compared control group t116227 p02 2tailed systolic blood pressure 06 mmhg 95 ci 7423 6301 hemoglobin a1c 45 mmolmol 95 ci 13099 4710 lower intervention group compared control group changes intentional nonadherence nonintentional nonadherence explained improvements medication adherence intervention group beta074 se0464 p04 control group beta00 se 135 p37 intervention 100 fidelity median 12 days engagement 76 overall satisfaction conclusions trial first conducted united kingdom showed among nonadherent patients either hypertension type 2 diabetes highly tailored digital intervention effective improving treatment adherence feasible obtain clinically meaningful outcomes changes intentional nonintentional nonadherence predicted improvements medication adherence intervention high fidelity engagement satisfaction future research using rigorous design needed evaluate clinical effectiveness costeffectiveness intervention primary care trial registration international standard randomized controlled trial number isrctn 10668149 httpwwwcontrolledtrialscomisrctn10668149