Rationale and design of the regimen education and messaging in diabetes (REMinD) trial

Rachel O'Conor; Marina Arvanitis; Guisselle Wismer; Lauren Opsasnick; Angela Sanchez Muñoz; Joseph Kannry; Jenny J. Lin; Darren Kaiser; Mary J. Kwasny; Stephen D. Persell; Ruth Parker; Alastair J.J. Wood; Alex D. Federman; Michael S. Wolf

doi:10.1016/j.cct.2019.06.016

Rationale and design of the regimen education and messaging in diabetes (REMinD) trial

Rachel O'Conor^*, Marina Arvanitis, Guisselle Wismer, Lauren Opsasnick, Angela Sanchez Muñoz, Joseph Kannry, Jenny J. Lin, Darren Kaiser, Mary J. Kwasny, Stephen D. Persell, Ruth Parker, Alastair J.J. Wood, Alex D. Federman, Michael S. Wolf

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Background: Individuals with type 2 diabetes manage complex multi-drug regimens, but nearly half of all patients do not consistently take the dose prescribed for them, and therefore may not receive the full potential therapeutic benefit. Both patient and health system factors contribute to achieving and maintaining medication adherence. To determine if patients with type 2 diabetes who are concurrently managing other chronic conditions could improve their adherence, we devised and are testing a multifaceted, primary care-based strategy to provide health literacy-appropriate and language concordant regimen information, guidance and reminders. Objective: We are testing the effectiveness of an electronic health record (EHR) based strategy and short message service (SMS) text reminders to help patients with type 2 diabetes adhere to their medications. Methods: We are conducting a 3-arm, multi-site trial to test and compare the effectiveness of the EHR, and EHR + SMS text reminder strategies compared to usual care on medication adherence. Our goal is to enroll a total of 900 English or Spanish-speaking patients with type 2 diabetes and hemoglobin A1C value ≥7.5%. Enrolled participants will complete interviews at baseline and 3 and 6 months following their baseline interview. Conclusions: Our trial is evaluating practical, clinic-based, scalable, evidence-based solutions for patients with type 2 diabetes managing complex medication regimens. Our findings will evaluate strategies that can be implemented broadly in primary care practices, and programmed as defaults within EHRs to support appropriate medication adherence to allow the widespread implementation of those strategies.

Original language	English (US)
Pages (from-to)	46-52
Number of pages	7
Journal	Contemporary Clinical Trials
Volume	83
DOIs	https://doi.org/10.1016/j.cct.2019.06.016
State	Published - Aug 2019

Keywords

Diabetes
Electronic health record
Health literacy
Medication adherence
Primary care
Text messaging

ASJC Scopus subject areas

Pharmacology (medical)

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O'Conor, R., Arvanitis, M., Wismer, G., Opsasnick, L., Sanchez Muñoz, A., Kannry, J., Lin, J. J., Kaiser, D., Kwasny, M. J., Persell, S. D., Parker, R., Wood, A. J. J., Federman, A. D., & Wolf, M. S. (2019). Rationale and design of the regimen education and messaging in diabetes (REMinD) trial. Contemporary Clinical Trials, 83, 46-52. https://doi.org/10.1016/j.cct.2019.06.016

O'Conor, Rachel ; Arvanitis, Marina ; Wismer, Guisselle ; Opsasnick, Lauren ; Sanchez Muñoz, Angela ; Kannry, Joseph ; Lin, Jenny J. ; Kaiser, Darren ; Kwasny, Mary J. ; Persell, Stephen D. ; Parker, Ruth ; Wood, Alastair J.J. ; Federman, Alex D. ; Wolf, Michael S. / Rationale and design of the regimen education and messaging in diabetes (REMinD) trial. In: Contemporary Clinical Trials. 2019 ; Vol. 83. pp. 46-52.

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title = "Rationale and design of the regimen education and messaging in diabetes (REMinD) trial",

abstract = "Background: Individuals with type 2 diabetes manage complex multi-drug regimens, but nearly half of all patients do not consistently take the dose prescribed for them, and therefore may not receive the full potential therapeutic benefit. Both patient and health system factors contribute to achieving and maintaining medication adherence. To determine if patients with type 2 diabetes who are concurrently managing other chronic conditions could improve their adherence, we devised and are testing a multifaceted, primary care-based strategy to provide health literacy-appropriate and language concordant regimen information, guidance and reminders. Objective: We are testing the effectiveness of an electronic health record (EHR) based strategy and short message service (SMS) text reminders to help patients with type 2 diabetes adhere to their medications. Methods: We are conducting a 3-arm, multi-site trial to test and compare the effectiveness of the EHR, and EHR + SMS text reminder strategies compared to usual care on medication adherence. Our goal is to enroll a total of 900 English or Spanish-speaking patients with type 2 diabetes and hemoglobin A1C value ≥7.5%. Enrolled participants will complete interviews at baseline and 3 and 6 months following their baseline interview. Conclusions: Our trial is evaluating practical, clinic-based, scalable, evidence-based solutions for patients with type 2 diabetes managing complex medication regimens. Our findings will evaluate strategies that can be implemented broadly in primary care practices, and programmed as defaults within EHRs to support appropriate medication adherence to allow the widespread implementation of those strategies.",

keywords = "Diabetes, Electronic health record, Health literacy, Medication adherence, Primary care, Text messaging",

author = "Rachel O'Conor and Marina Arvanitis and Guisselle Wismer and Lauren Opsasnick and {Sanchez Mu{\~n}oz}, Angela and Joseph Kannry and Lin, {Jenny J.} and Darren Kaiser and Kwasny, {Mary J.} and Persell, {Stephen D.} and Ruth Parker and Wood, {Alastair J.J.} and Federman, {Alex D.} and Wolf, {Michael S.}",

note = "Funding Information: This study was funded by a grant from the National Institute of Nursing Research ( R01NR01544 ). The funding agency played no role in the study design, collection of data, analysis or interpretation of data. Funding Information: Dr. Michael Wolf serves as an advisor for medication risk communication to the Luto UK usability testing company. In addition, he is a member of the Technical Advisory Group for the AB Imbev Foundation, addressing harmful drinking reduction. Dr. Wolf also is principal investigator on grants received from Eli Lilly, Merck, Sharpe & Dohme, Amgen (student predoctoral fellowship awards). He also has served as a paid consultant on health literacy-related medication information design projects funded by Pfizer. All other authors report no conflicts of interest.",

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Rationale and design of the regimen education and messaging in diabetes (REMinD) trial. / O'Conor, Rachel ; Arvanitis, Marina; Wismer, Guisselle; Opsasnick, Lauren; Sanchez Muñoz, Angela; Kannry, Joseph; Lin, Jenny J.; Kaiser, Darren; Kwasny, Mary J.; Persell, Stephen D.; Parker, Ruth; Wood, Alastair J.J.; Federman, Alex D.; Wolf, Michael S.

In: Contemporary Clinical Trials, Vol. 83, 08.2019, p. 46-52.

Research output: Contribution to journal › Article › peer-review

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AU - O'Conor, Rachel

AU - Arvanitis, Marina

AU - Wismer, Guisselle

AU - Opsasnick, Lauren

AU - Sanchez Muñoz, Angela

AU - Kannry, Joseph

AU - Lin, Jenny J.

AU - Kaiser, Darren

AU - Kwasny, Mary J.

AU - Persell, Stephen D.

AU - Parker, Ruth

AU - Wood, Alastair J.J.

AU - Federman, Alex D.

AU - Wolf, Michael S.

N1 - Funding Information: This study was funded by a grant from the National Institute of Nursing Research ( R01NR01544 ). The funding agency played no role in the study design, collection of data, analysis or interpretation of data. Funding Information: Dr. Michael Wolf serves as an advisor for medication risk communication to the Luto UK usability testing company. In addition, he is a member of the Technical Advisory Group for the AB Imbev Foundation, addressing harmful drinking reduction. Dr. Wolf also is principal investigator on grants received from Eli Lilly, Merck, Sharpe & Dohme, Amgen (student predoctoral fellowship awards). He also has served as a paid consultant on health literacy-related medication information design projects funded by Pfizer. All other authors report no conflicts of interest.

PY - 2019/8

Y1 - 2019/8

N2 - Background: Individuals with type 2 diabetes manage complex multi-drug regimens, but nearly half of all patients do not consistently take the dose prescribed for them, and therefore may not receive the full potential therapeutic benefit. Both patient and health system factors contribute to achieving and maintaining medication adherence. To determine if patients with type 2 diabetes who are concurrently managing other chronic conditions could improve their adherence, we devised and are testing a multifaceted, primary care-based strategy to provide health literacy-appropriate and language concordant regimen information, guidance and reminders. Objective: We are testing the effectiveness of an electronic health record (EHR) based strategy and short message service (SMS) text reminders to help patients with type 2 diabetes adhere to their medications. Methods: We are conducting a 3-arm, multi-site trial to test and compare the effectiveness of the EHR, and EHR + SMS text reminder strategies compared to usual care on medication adherence. Our goal is to enroll a total of 900 English or Spanish-speaking patients with type 2 diabetes and hemoglobin A1C value ≥7.5%. Enrolled participants will complete interviews at baseline and 3 and 6 months following their baseline interview. Conclusions: Our trial is evaluating practical, clinic-based, scalable, evidence-based solutions for patients with type 2 diabetes managing complex medication regimens. Our findings will evaluate strategies that can be implemented broadly in primary care practices, and programmed as defaults within EHRs to support appropriate medication adherence to allow the widespread implementation of those strategies.

AB - Background: Individuals with type 2 diabetes manage complex multi-drug regimens, but nearly half of all patients do not consistently take the dose prescribed for them, and therefore may not receive the full potential therapeutic benefit. Both patient and health system factors contribute to achieving and maintaining medication adherence. To determine if patients with type 2 diabetes who are concurrently managing other chronic conditions could improve their adherence, we devised and are testing a multifaceted, primary care-based strategy to provide health literacy-appropriate and language concordant regimen information, guidance and reminders. Objective: We are testing the effectiveness of an electronic health record (EHR) based strategy and short message service (SMS) text reminders to help patients with type 2 diabetes adhere to their medications. Methods: We are conducting a 3-arm, multi-site trial to test and compare the effectiveness of the EHR, and EHR + SMS text reminder strategies compared to usual care on medication adherence. Our goal is to enroll a total of 900 English or Spanish-speaking patients with type 2 diabetes and hemoglobin A1C value ≥7.5%. Enrolled participants will complete interviews at baseline and 3 and 6 months following their baseline interview. Conclusions: Our trial is evaluating practical, clinic-based, scalable, evidence-based solutions for patients with type 2 diabetes managing complex medication regimens. Our findings will evaluate strategies that can be implemented broadly in primary care practices, and programmed as defaults within EHRs to support appropriate medication adherence to allow the widespread implementation of those strategies.

KW - Diabetes

KW - Electronic health record

KW - Health literacy

KW - Medication adherence

KW - Primary care

KW - Text messaging

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