Effects of monitoring and brief messaging interventions on medication adherence for people with type2 diabetes

Abstract

Background There is enthusiasm for interventions that monitor behaviour and send brief messages to promote medication adherence. We conducted a systematic literature review to examine the effects of such interventions in patients with type 2 diabetes, and their basis in explicit theory. Methods Systematic electronic searches of five electronic databases identified eleven eligible randomised trials (fifteen interventions) with 4480 patients that reported effects on medication adherence. Findings Three interventions were based on delivering brief messages, six on monitoring of medication adherence, and six used both strategies. Only one study presented a low risk of bias. Improvements in self-reported medication adherence were observed in six interventions, although effect sizes were generally moderate. A meta-analysis of interventions combining monitoring and messaging strategies showed no overall difference in effect size between intervention and control groups (Cohen’s d=0.05) Only six of the interventions had any explicit theoretical basis, and even these demonstrated little use of theory. Discussion Although interventions based on messaging and monitoring have the potential to improve medication adherence, additional high-quality research is needed, with greater use of theories of behaviour change.