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 Jeanne Kwasny, Stephen D Persell, Ruth Parker, Alastair J.J. Wood, Alex D. Federman, Michael Wolf

*Corresponding author for this work

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)46-52
Number of pages7
JournalContemporary Clinical Trials
Volume83
DOIs
StatePublished - Aug 1 2019

Fingerprint

Type 2 Diabetes Mellitus
Education
Medication Adherence
Electronic Health Records
Text Messaging
Primary Health Care
Interviews
Health Literacy
Hemoglobins
Language
Health
Pharmaceutical Preparations
Therapeutics

Keywords

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

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

O'Conor, Rachel ; Arvanitis, Marina ; Wismer, Guisselle ; Opsasnick, Lauren ; Sanchez Muñoz, Angela ; Kannry, Joseph ; Lin, Jenny J. ; Kaiser, Darren ; Kwasny, Mary Jeanne ; Persell, Stephen D ; Parker, Ruth ; Wood, Alastair J.J. ; Federman, Alex D. ; Wolf, Michael. / 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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O'Conor, R, Arvanitis, M, Wismer, G, Opsasnick, L, Sanchez Muñoz, A, Kannry, J, Lin, JJ, Kaiser, D, Kwasny, MJ, Persell, SD, Parker, R, Wood, AJJ, Federman, AD & Wolf, M 2019, 'Rationale and design of the regimen education and messaging in diabetes (REMinD) trial', Contemporary Clinical Trials, vol. 83, pp. 46-52. https://doi.org/10.1016/j.cct.2019.06.016

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 Jeanne; Persell, Stephen D; Parker, Ruth; Wood, Alastair J.J.; Federman, Alex D.; Wolf, Michael.

In: Contemporary Clinical Trials, Vol. 83, 01.08.2019, p. 46-52.

Research output: Contribution to journalArticle

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T1 - Rationale and design of the regimen education and messaging in diabetes (REMinD) trial

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 Jeanne

AU - Persell, Stephen D

AU - Parker, Ruth

AU - Wood, Alastair J.J.

AU - Federman, Alex D.

AU - Wolf, Michael

PY - 2019/8/1

Y1 - 2019/8/1

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.

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