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Medication Adherence App for Food Pantry Clients With Diabetes: A Feasibility Study

      Highlights

      • Community needs assessment showed a high need for interventions to improve diabetes outcomes.
      • This study determined the feasibility of using a mobile phone app in a community food pantry to improve diabetes medication adherence among minority racial population.
      • Participants used the Wellth mobile phone app featuring text message reminders and incentives. Government-sponsored insurance (Medicaid) paid the app cost and incentives via the Performing Provider Systems.
      • It is feasible to use mobile phone apps to improve medication adherence among urban low-income population. A clinically significant improvement in medication adherence (93%) was captured by mobile phone cameras.

      Abstract

      Low-income food pantry clients are unable to adhere to the diet and physical activity recommendations of the American Diabetes Association. The aim of the study is to test the feasibility of using a mobile phone app to improve diabetes medication adherence. Clients with uncontrolled type 2 diabetes were enrolled in a mobile phone app featuring 70 days of text message reminders and incentives. The app and the 4-item Morisky Medication Adherence Scale evaluated medication adherence. Clinically significant medication adherence of 93% was achieved with use of the app. Phone app use is feasible among urban low-income clients to improve medication adherence.

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      References

        • US Department of Health and Human Services. Centers for Disease Control and Prevention
        National Diabetes Statistics Report.
        Centers for Disease Control and Prevention, 2020
        • Center for Disease Control and Prevention
        National Diabetes Statistic Report.
        • Shrestha S.S.
        • Honeycutt A.A.
        • Yang W.
        • et al.
        Economic costs attributable to diabetes in each US state.
        Diabetes Care. 2018; 41: 2526-2534https://doi.org/10.2337/dc18-1179
        • Davis P.C.
        The 18 most expensive U.S. medical conditions.
        • American Diabetes Association
        Standards of Medical Care in Diabetes—2019 Abridged for Primary Care Providers.
        Clin Diabetes. 2019; 37: 11-34https://doi.org/10.2337/cd18-0105
        • Smalls B.L.
        • Gregory C.M.
        • Zoller J.S.
        • Egede L.E.
        Assessing the relationship between neighborhood factors and diabetes related health outcomes and self-care behaviors.
        BMC Health Serv Res. 2015; 15: 445-457https://doi.org/10.1186/s12913-015-1086-7
        • Walker R.J.
        • Strom Williams J.
        • Egede L.E.
        Influence of race, ethnicity and social determinants of health on diabetes outcomes.
        Am J Med Sci. 2016; 351: 366-373https://doi.org/10.1016/j.amjms.2016.01.008
        • Osborn C.Y.
        • Mayberry L.S.
        • Kim J.M.
        Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
        J Clin Pharm Ther. 2016; 41: 256-259https://doi.org/10.1111/jcpt.12360
        • Vrijens B.
        • DeGeest S.
        • Hughes D.A.
        • et al.
        A new taxonomy for describing and defining adherence to medications.
        Br J Clin Pharmacol. 2012; 73: 691-705https://doi.org/10.1111/j.1365-2125.2012.04167.x
        • Billimek J.
        • August K.J.
        Cost and beliefs: understanding individual- and neighborhood-level correlates of medication nonadherence among Mexican Americans with type 2 diabetes.
        Health Psychol. 2014; 33: 1602-1605https://doi.org/10.1037/hea0000020
        • Fan J.
        • Lyons S.
        • Goodman M.
        • Blanchard M.
        • Kaphingst K.
        Relationship between health literacy and unintentional and intentional medication nonadherence in medically underserved patients with type 2 diabetes.
        Diabetes Educ. 2016; 42: 199-208https://doi.org/10.1177/0145721715624969
        • Nelson L.A.
        • Wallston K.A.
        • Kripalani S.
        • LeStourgeon L.M.
        • Williamson S.E.
        • Mayberry L.S.
        Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model.
        Diabetes Res Clin Pract. 2018; 142: 374-384https://doi.org/10.1016/j.diabres.2018.05.046
        • Heerman W.J.
        • Wallston K.A.
        • Osborn C.Y.
        • et al.
        Food insecurity is associated with diabetes self-care behaviours and glycaemic control.
        Diabet Med. 2015; 33: 844-850https://doi.org/10.1111/dme.12896
        • Ippolito M.M.
        • Lyles C.R.
        • Prendergast K.
        • Marshall M.B.
        • Waxman E.
        • Seligman H.K.
        Food insecurity and diabetes self-management among food pantry clients.
        Public Health Nutr. 2017; 20: 183-189https://doi.org/10.1017/S1368980016001786
        • Silverman J.
        • Krieger J.
        • Kiefer M.
        • Hebert P.
        • Robinson J.
        • Nelson K.
        The relationship between food insecurity and depression, diabetes distress and medication adherence among low-income patients with poorly- controlled diabetes.
        J Gen Intern Med. 2015; 30: 1476-1480https://doi.org/10.1007/s11606-015-3351-1
        • Seligman H.K.
        • Lyles C.
        • Marshall M.B.
        • et al.
        A pilot food bank intervention featuring diabetes-appropriate food improved glycemic control among clients in three states.
        Health Aff (Millwood). 2015; 34: 1956-1963https://doi.org/10.1377/hlthaff.2015.0641
        • Arora S.
        • Peters A.L.
        • Burner E.
        • Lam C.N.
        • Menchine M.
        Trial to examine text message–based mHealth in emergency department patients with diabetes (TExT-MED): a randomized controlled trial.
        Ann Emerg Med. 2014; 63: 745-754https://doi.org/10.1016/j.annemergmed.2013.10.012
        • Thakkar J.
        • Kurup R.
        • Laba T.L.
        • et al.
        Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis.
        JAMA Intern Med. 2016; 176: 340-349https://doi.org/10.1001/jamainternmed.2015.7667
        • Vervloet M.
        • van Dijk L.
        • Santen-Reestman J.
        • et al.
        SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored.
        Int J Med Inform. 2012; 81: 594-604https://doi.org/10.1186/1472-6963-11-5
        • Raiff B.R.
        • Jarvis B.P.
        • Dallery J.
        Text-message reminders plus incentives increase adherence to antidiabetic medication in adults with type 2 diabetes.
        J Appl Behav Anal. 2016; 49: 947-953https://doi.org/10.1002/jaba.337
        • US Department of Health and Human Services
        Agency for Healthcare Research and Quality. 2017 National healthcare quality and disparities report.
        US Department of Health and Human Services, 2018 (AHRQ publication 18-0033-EF)
        • Odlum M.
        • Moise N.
        • Kronish I.M.
        • et al.
        Trends in poor health indicators among black and Hispanic middle-aged and older adults in the United States, 1999-2018.
        JAMA Netw Open. 2020; 3e2025134https://doi.org/10.1001/jamanetworkopen.2020.25134
      1. Wellth mobile application.
      2. Community needs assessment report.
        • New York City Department of Health and Mental Hygiene
        Neighborhood walkability and physical activity in New York City.
        • Lynagh M.C.
        • Sanson-Fisher R.W.
        • Bonevski B.
        What’s good for the goose is good for the gander. Guiding principles for the use of financial incentives in health behaviour change.
        Int J Behav Med. 2013; 20: 114-120
        • Kamenica E.
        Behavioral economics and psychology of incentives.
        Annu Rev Econ. 2012; 4: 427-452https://doi.org/10.1146/annurev-economics-080511-110909
        • Kahneman D.
        • Knetsch J.L.
        • Thaler R.H.
        Anomalies: the endowment effect, loss aversion, and status quo bias.
        J Econ Perspect. 1991; 5: 193-206https://doi.org/10.1257/jep.5.1.193
      3. Delivery System Reform Incentive Payment Program.
        • Morisky D.E.
        • Green L.W.
        • Levine D.M.
        Concurrent and predictive validity of a self-reported measure of medication adherence.
        Med Care. 1986; 24: 67-74https://doi.org/10.1097/00005650-198601000-00007
        • Chamany S.
        • Walker E.A.
        • Schechter C.B.
        • et al.
        Telephone intervention to improve diabetes control: a randomized trial in the New York City A1c Registry.
        Am J Prevent Med. 2015; 49: 832-841https://doi.org/10.1016/j.amepre.2015.04.016

      Biography

      Sandhya Nadadur, DNP, FNP-BC, AGPCNP-C, is an adjunct professor at the College of Staten Island, City University of New York in Staten Island and can be contacted at [email protected]