Effects of interventions promoting monitoring of medication use and brief messaging on medication adherence for people with Type 2 diabetes: a systematic review of randomized trials
Open accessAbstract
Aims: To assess the impact of interventions promoting the monitoring of medication use and brief messaging to support medication adherence in patients with Type 2 diabetes mellitus, and to investigate the extent of theory use to guide intervention development. Methods: We systematically searched for controlled trials, published from 1990 onwards in Medline, Embase, CINAHL, Psyc INFO and the Cochrane library, that evaluated interventions based on monitoring and brief messaging to support medication adherence in patients with Type 2 diabetes, to examine the effectiveness of such interventions. Results: A total of 11 trials, comparing 15 interventions, were identified. Only a small minority presented a low risk of bias. Three interventions were based on delivering brief messages, six were based on monitoring medication adherence, and six used both strategies. Messaging interventions included the use of short message service text messages, web‐based feedback, and messages delivered through monitoring devices. Monitoring interventions included remote self‐reporting of medication and telephone calls with healthcare staff. Improvements in medication adherence were observed in six interventions, although effect sizes were generally moderate. Only two interventions improved both adherence and clinical outcomes. A meta‐analysis of five trials (eight interventions) combining monitoring and messaging strategies showed that the pooled difference in medication adherence between intervention and control was moderate and not statistically significant [standardized mean difference = 0.22 (95% CI −0.05; 0.49)]. Only four trials were based on explicit theoretical frameworks. Conclusions: Although interventions based on messaging and monitoring have the potential to improve medication adherence in patients with Type 2 diabetes, evidence of their efficacy is limited and additional high‐quality, theory‐based research is needed.
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Interventions to support medication adherence can lead to improved health outcomes.
“Interventions to support medication adherence can lead to improved health outcomes [11].”
Taking into account quality assessment, explicit self-management focus, and total population size, 8 reviews received an evidence weighting of 3 stars, 23 received 2 stars, 21 received 1 star, and 1 received no stars.
“Taking into account quality assessment, explicit self-management focus, and total population size, 8 reviews received an evidence weighting of 3 stars [16,21,25,26,38,45,53,56], 23 received 2 stars [22,24,27-31, 33,37,40,42,44,46,49,50,52,54,55,58,62,63,67,68], 21 received 1 star [19,20,23,32,34-36,39,43,47,48,51,57, 59-61,64-66,69,70], and 1 received no stars [41].”
Farmer et al.'s review did not report the impact of medication adherence interventions on glycemic control or other outcomes.
“The impact of this on glycemic control or other outcomes was not reported.”
In Farmer et al.'s 3-star weighted review, meta-analysis of 8 interventions using remote monitoring, messaging, or a combination showed a nonsignificant effect size on medication adherence.
“A 3-star weighted review by Farmer et al analyzed the impact on medication adherence of interventions using remote monitoring, messaging, or a combination [26]. Meta-analysis of 8 interventions showed a nonsignificant effect size”
In Farmer et al.'s review, only 6 of 15 interventions reported some improvement in medication adherence.
“only 6 of the 15 interventions reported some improvement in medication adherence.”
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Self-citation
- Authors
- Farmer, A. J., McSharry, J., Rowbotham, S., McGowan, L., Ricci‐Cabello, I., & French, D. P.
- Affiliations
- Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK
- Ollscoil na Gaillimhe – University of Galway (IE)
- University of Manchester (GB)
- University of Oxford (GB)
- Corresponding author
- French, D. P.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2015-11-17
- Volume
- 33
- Issue
- 5
- Pages
- 565-579
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W1958378891
- Cited by
- 106
- References
- 68
- Citations by year
- 2025: 5 · 2024: 10 · 2023: 12 · 2022: 11 · 2021: 23 · 2020: 8 · 2019: 15 · 2018: 9 · 2017: 8 · 2016: 5
- FWCI
- 1.24
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) (submittedVersion, cc-by-nc-nd)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion)
- University of Galway Research Repository (submittedVersion, cc-by-nc)
- Research Repository UCD (University College Dublin) (cc-by-nc)
- Funders
- National Institute on Handicapped Research
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- medication adherence, type 2 diabetes, text messaging, web-based feedback, theory-based intervention, intervention effectiveness
- MeSH terms
- Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Middle Aged, Patient Education as Topic, Psychological Theory, Telephone, Randomized Controlled Trials as Topic, Drug Monitoring, Monitoring, Ambulatory, Evidence-Based Medicine, Internet, Feedback, Psychological, Medication Adherence, Precision Medicine, Self Report, Text Messaging
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