Trial Outcomes & Findings for Improving Medication Adherence Among Underserved Patients With Type 2 Diabetes (NCT NCT02409329)

NCT ID: NCT02409329

Last Updated: 2020-08-17

Results Overview

as measured by Hemoglobin A1c (%) with higher values indicating worse glycemic control and an improvement of 0.5% considered clinically meaningful

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

512 participants

Primary outcome timeframe

Baseline, 3 months, 6 months, 12 months, 15 months

Results posted on

2020-08-17

Participant Flow

6 participants were administratively withdrawn prior to randomization; 5 were unreachable during a pre-determined run-in period after enrollment, 1 behaved inappropriately with a research assistant during enrollment

Participant milestones

Participant milestones
Measure
REACH
Participants will receive REACH text messages (individual-focused text messaging tailored to user's individual barriers to adherence and targeted to address other self-care behaviors) for 12 months. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. REACH: The intervention consists of daily text messaging tailored to user's individual barriers to medication adherence, text messages assessing user's adherence with feedback on progress, plus text messaging targeting other self-care behaviors. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
REACH + FAMS
In addition to the REACH text messages tailored to user's individual barriers to adherence, participants will receive FAMS components (monthly phone coaching and text messages supporting a goal set in coaching, plus the option to invite a family member/support person to receive text messages) for six months. After 6 months, participants in this arm will receive REACH text messages only. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions. REACH + FAMS: The intervention consists of REACH individually-focused text mes
Helpline and A1c Results
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Overall Study
STARTED
127
126
253
Overall Study
COMPLETED
122
120
244
Overall Study
NOT COMPLETED
5
6
9

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Improving Medication Adherence Among Underserved Patients With Type 2 Diabetes

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
REACH
n=127 Participants
Participants will receive REACH text messages (individual-focused text messaging tailored to user's individual barriers to adherence and targeted to address other self-care behaviors) for 12 months. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. REACH: The intervention consists of daily text messaging tailored to user's individual barriers to medication adherence, text messages assessing user's adherence with feedback on progress, plus text messaging targeting other self-care behaviors. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
REACH + FAMS
n=126 Participants
In addition to the REACH text messages tailored to user's individual barriers to adherence, participants will receive FAMS components (monthly phone coaching and text messages supporting a goal set in coaching, plus the option to invite a family member/support person to receive text messages) for 6 months. After six months, participants in this arm will receive REACH text messages only. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions. REACH + FAMS: The intervention consists of REACH individually-focused text mes
Helpline and A1c Results
n=253 Participants
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Total
n=506 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Categorical
Between 18 and 65 years
109 Participants
n=5 Participants
97 Participants
n=7 Participants
206 Participants
n=5 Participants
412 Participants
n=4 Participants
Age, Categorical
>=65 years
18 Participants
n=5 Participants
29 Participants
n=7 Participants
47 Participants
n=5 Participants
94 Participants
n=4 Participants
Age, Continuous
55.8 years
STANDARD_DEVIATION 9.4 • n=5 Participants
55.7 years
STANDARD_DEVIATION 10.2 • n=7 Participants
56.1 years
STANDARD_DEVIATION 9.4 • n=5 Participants
55.9 years
STANDARD_DEVIATION 9.6 • n=4 Participants
Sex: Female, Male
Female
70 Participants
n=5 Participants
69 Participants
n=7 Participants
135 Participants
n=5 Participants
274 Participants
n=4 Participants
Sex: Female, Male
Male
57 Participants
n=5 Participants
57 Participants
n=7 Participants
118 Participants
n=5 Participants
232 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
8 Participants
n=5 Participants
8 Participants
n=7 Participants
15 Participants
n=5 Participants
31 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
116 Participants
n=5 Participants
111 Participants
n=7 Participants
224 Participants
n=5 Participants
451 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
3 Participants
n=5 Participants
7 Participants
n=7 Participants
14 Participants
n=5 Participants
24 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
4 Participants
n=4 Participants
Race (NIH/OMB)
Asian
3 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
8 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
51 Participants
n=5 Participants
49 Participants
n=7 Participants
98 Participants
n=5 Participants
198 Participants
n=4 Participants
Race (NIH/OMB)
White
64 Participants
n=5 Participants
63 Participants
n=7 Participants
128 Participants
n=5 Participants
255 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
2 Participants
n=5 Participants
5 Participants
n=7 Participants
6 Participants
n=5 Participants
13 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
6 Participants
n=5 Participants
6 Participants
n=7 Participants
15 Participants
n=5 Participants
27 Participants
n=4 Participants
Region of Enrollment
United States
127 participants
n=5 Participants
126 participants
n=7 Participants
253 participants
n=5 Participants
506 participants
n=4 Participants
Hemoglobin A1c (%)
8.72 percent
STANDARD_DEVIATION 1.79 • n=5 Participants
8.56 percent
STANDARD_DEVIATION 1.90 • n=7 Participants
8.53 percent
STANDARD_DEVIATION 1.80 • n=5 Participants
8.58 percent
STANDARD_DEVIATION 1.82 • n=4 Participants
Medication Adherence - Summary of Diabetes Self-Care Activities medication subscale
6.25 days in a week
STANDARD_DEVIATION 1.37 • n=5 Participants
6.37 days in a week
STANDARD_DEVIATION 1.09 • n=7 Participants
6.41 days in a week
STANDARD_DEVIATION 1.16 • n=5 Participants
6.36 days in a week
STANDARD_DEVIATION 1.20 • n=4 Participants
Medication Adherence - Adherence to Refills and Medications Scale for Diabetes
39.90 score on a scale
STANDARD_DEVIATION 3.74 • n=5 Participants
39.66 score on a scale
STANDARD_DEVIATION 3.54 • n=7 Participants
40.21 score on a scale
STANDARD_DEVIATION 3.34 • n=5 Participants
39.99 score on a scale
STANDARD_DEVIATION 3.54 • n=4 Participants
Use of dietary information - Personal Diabetes Questionnaire
3.09 score on a scale
STANDARD_DEVIATION 1.74 • n=5 Participants
2.85 score on a scale
STANDARD_DEVIATION 1.57 • n=7 Participants
2.96 score on a scale
STANDARD_DEVIATION 1.70 • n=5 Participants
2.97 score on a scale
STANDARD_DEVIATION 1.68 • n=4 Participants
Problem eating behaviors - Personal Diabetes Questionnaire
3.23 score on a scale
STANDARD_DEVIATION 1.08 • n=5 Participants
3.43 score on a scale
STANDARD_DEVIATION 1.04 • n=7 Participants
3.35 score on a scale
STANDARD_DEVIATION 1.16 • n=5 Participants
3.34 score on a scale
STANDARD_DEVIATION 1.11 • n=4 Participants
MET-minutes per week - International Physical Activity Questionnaire-short form
2565.11 MET-minutes per week
STANDARD_DEVIATION 3108.48 • n=5 Participants
1836.23 MET-minutes per week
STANDARD_DEVIATION 2183.39 • n=7 Participants
2348.91 MET-minutes per week
STANDARD_DEVIATION 2853.58 • n=5 Participants
2274.58 MET-minutes per week
STANDARD_DEVIATION 2777.96 • n=4 Participants

PRIMARY outcome

Timeframe: Baseline, 3 months, 6 months, 12 months, 15 months

Population: We compared participants receiving the REACH intervention (combining REACH and REACH + FAMS) with participants not receiving REACH (in condition Helpline and A1c Results).

as measured by Hemoglobin A1c (%) with higher values indicating worse glycemic control and an improvement of 0.5% considered clinically meaningful

Outcome measures

Outcome measures
Measure
REACH
n=253 Participants
Participants will receive REACH text messages (individual-focused text messaging tailored to user's individual barriers to adherence and targeted to address other self-care behaviors) for 12 months. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. REACH: The intervention consists of daily text messaging tailored to user's individual barriers to medication adherence, text messages assessing user's adherence with feedback on progress, plus text messaging targeting other self-care behaviors. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
n=253 Participants
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Change in Glycemic Control as Indicated by Hemoglobin A1c (HbA1c)
3 months
8.29 percent
Standard Deviation 1.49
8.59 percent
Standard Deviation 1.65
Change in Glycemic Control as Indicated by Hemoglobin A1c (HbA1c)
15 months
8.59 percent
Standard Deviation 1.81
8.61 percent
Standard Deviation 1.95
Change in Glycemic Control as Indicated by Hemoglobin A1c (HbA1c)
6 months
8.32 percent
Standard Deviation 1.65
8.57 percent
Standard Deviation 2.15
Change in Glycemic Control as Indicated by Hemoglobin A1c (HbA1c)
12 months
8.66 percent
Standard Deviation 1.97
8.70 percent
Standard Deviation 2.10

SECONDARY outcome

Timeframe: Baseline, 3 months, 6 months, 12 months, 15 months

Population: We compared participants receiving the REACH intervention (combining REACH and REACH + FAMS) with participants not receiving REACH (in condition Helpline and A1c Results).

as measured by the Summary of Diabetes Self-Care Activities (SDSCA) Medications subscale; response options are days in the last week ranging from 0 to 7, with 7 representing perfect adherence

Outcome measures

Outcome measures
Measure
REACH
n=253 Participants
Participants will receive REACH text messages (individual-focused text messaging tailored to user's individual barriers to adherence and targeted to address other self-care behaviors) for 12 months. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. REACH: The intervention consists of daily text messaging tailored to user's individual barriers to medication adherence, text messages assessing user's adherence with feedback on progress, plus text messaging targeting other self-care behaviors. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
n=253 Participants
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Change in Self-reported Medication Adherence
3 months
6.59 days per week
Standard Deviation 0.96
6.38 days per week
Standard Deviation 1.25
Change in Self-reported Medication Adherence
12 months
6.50 days per week
Standard Deviation 1.09
6.27 days per week
Standard Deviation 1.46
Change in Self-reported Medication Adherence
15 months
6.36 days per week
Standard Deviation 1.22
6.18 days per week
Standard Deviation 1.45
Change in Self-reported Medication Adherence
6 months
6.64 days per week
Standard Deviation 0.89
6.24 days per week
Standard Deviation 1.51

SECONDARY outcome

Timeframe: Baseline, 3 months, 6 months, 12 months, 15 months

Population: We compared participants receiving the REACH intervention (combining REACH and REACH + FAMS) with participants not receiving REACH (in condition Helpline and A1c Results).

as measured by the Adherence to Refills and Medications Scale for Diabetes (ARMS-D); reverse coded such that higher scores indicate better adherence on a scale from 11 to 44

Outcome measures

Outcome measures
Measure
REACH
n=253 Participants
Participants will receive REACH text messages (individual-focused text messaging tailored to user's individual barriers to adherence and targeted to address other self-care behaviors) for 12 months. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. REACH: The intervention consists of daily text messaging tailored to user's individual barriers to medication adherence, text messages assessing user's adherence with feedback on progress, plus text messaging targeting other self-care behaviors. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
n=253 Participants
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Change in Self-reported Medication Adherence
3 months
40.4 score on a scale
Standard Deviation 3.62
40.4 score on a scale
Standard Deviation 3.45
Change in Self-reported Medication Adherence
6 months
40.6 score on a scale
Standard Deviation 3.48
40.2 score on a scale
Standard Deviation 3.49
Change in Self-reported Medication Adherence
12 months
40.3 score on a scale
Standard Deviation 3.48
40.2 score on a scale
Standard Deviation 3.99
Change in Self-reported Medication Adherence
15 months
40.5 score on a scale
Standard Deviation 3.24
40.4 score on a scale
Standard Deviation 3.90

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, 3 months, 6 months, 12 months, 15 months

Population: We compared participants receiving the REACH intervention (combining REACH and REACH + FAMS) with participants not receiving REACH (in condition Helpline and A1c Results).

as measured by the Personal Diabetes Questionnaire diet subscale "Use of information for decision making"; possible range 1-6, higher indicates more use of dietary information (better)

Outcome measures

Outcome measures
Measure
REACH
n=253 Participants
Participants will receive REACH text messages (individual-focused text messaging tailored to user's individual barriers to adherence and targeted to address other self-care behaviors) for 12 months. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. REACH: The intervention consists of daily text messaging tailored to user's individual barriers to medication adherence, text messages assessing user's adherence with feedback on progress, plus text messaging targeting other self-care behaviors. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
n=253 Participants
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Change in Adherence to Dietary Behavior
3 months
3.17 score on a scale
Standard Deviation 1.59
2.84 score on a scale
Standard Deviation 1.58
Change in Adherence to Dietary Behavior
6 months
3.34 score on a scale
Standard Deviation 1.56
2.93 score on a scale
Standard Deviation 1.62
Change in Adherence to Dietary Behavior
12 months
3.22 score on a scale
Standard Deviation 1.58
2.88 score on a scale
Standard Deviation 1.61
Change in Adherence to Dietary Behavior
15 months
3.17 score on a scale
Standard Deviation 1.65
3.01 score on a scale
Standard Deviation 1.77

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, 3 months, 6 months, 12 months, 15 months

Population: We compared participants receiving the REACH intervention (combining REACH and REACH + FAMS) with participants not receiving REACH (in condition Helpline and A1c Results).

Personal Diabetes Questionnaire diet subscale "Problem eating behavior"; possible range 1-6 with higher indicating more problem eating behavior (worse)

Outcome measures

Outcome measures
Measure
REACH
n=253 Participants
Participants will receive REACH text messages (individual-focused text messaging tailored to user's individual barriers to adherence and targeted to address other self-care behaviors) for 12 months. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. REACH: The intervention consists of daily text messaging tailored to user's individual barriers to medication adherence, text messages assessing user's adherence with feedback on progress, plus text messaging targeting other self-care behaviors. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
n=253 Participants
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Change in Adherence to Dietary Behavior
3 months
3.17 score on a scale
Standard Deviation 1.03
3.28 score on a scale
Standard Deviation 1.13
Change in Adherence to Dietary Behavior
6 months
3.11 score on a scale
Standard Deviation 0.95
3.18 score on a scale
Standard Deviation 1.06
Change in Adherence to Dietary Behavior
12 months
3.09 score on a scale
Standard Deviation 1.07
3.13 score on a scale
Standard Deviation 1.09
Change in Adherence to Dietary Behavior
15 months
3.18 score on a scale
Standard Deviation 1.15
3.18 score on a scale
Standard Deviation 1.11

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, 3 months, 6 months, 12 months, 15 months

Population: We compared participants receiving the REACH intervention (combining REACH and REACH + FAMS) with participants not receiving REACH (in condition Helpline and A1c Results).

as measured by International Physical Activity Questionnaire-Short form \[metabolic equivalent minutes (MET-minutes) per week\] where more MET-minutes per week indicates more physical activity

Outcome measures

Outcome measures
Measure
REACH
n=253 Participants
Participants will receive REACH text messages (individual-focused text messaging tailored to user's individual barriers to adherence and targeted to address other self-care behaviors) for 12 months. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. REACH: The intervention consists of daily text messaging tailored to user's individual barriers to medication adherence, text messages assessing user's adherence with feedback on progress, plus text messaging targeting other self-care behaviors. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
n=253 Participants
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Change in Physical Activity
3 months
2285 MET-minutes per week
Standard Deviation 2973
2139 MET-minutes per week
Standard Deviation 2501
Change in Physical Activity
6 months
2332 MET-minutes per week
Standard Deviation 3168
1991 MET-minutes per week
Standard Deviation 2547
Change in Physical Activity
12 months
2573 MET-minutes per week
Standard Deviation 3329
2273 MET-minutes per week
Standard Deviation 2883
Change in Physical Activity
15 months
2221 MET-minutes per week
Standard Deviation 2973
2239 MET-minutes per week
Standard Deviation 2774

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, 3 months, 6 months, 12 months, 15 months

Population: We compared participants receiving the REACH intervention only with those receiving REACH + FAMS and with participants not receiving REACH (in condition Helpline and A1c Results). This analysis was subsetted to participants with baseline HbA1c greater than or equal to 8.5% with the goal of improved power.

as measured by hemoglobin A1c (HbA1c, %) We may be under-powered to for these comparative analyses.

Outcome measures

Outcome measures
Measure
REACH
n=59 Participants
Participants will receive REACH text messages (individual-focused text messaging tailored to user's individual barriers to adherence and targeted to address other self-care behaviors) for 12 months. All participants will also receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. REACH: The intervention consists of daily text messaging tailored to user's individual barriers to medication adherence, text messages assessing user's adherence with feedback on progress, plus text messaging targeting other self-care behaviors. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
n=52 Participants
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Helpline and A1c Results
n=106 Participants
Participants assigned to the control group will complete measures at each time point and maintain care as usual (i.e., medical treatment and physician monitoring). All participants will receive text messages advising how to access their study A1c test results, receive quarterly newsletters on healthy living with diabetes, and have access to a Helpline for study- and diabetes medication-related questions. Helpline and A1c results: Participants complete study assessments, receive text messages advising how to access study A1c results, receive quarterly newsletters on healthy living with diabetes, and have access to a helpline for study- or diabetes medication-related questions.
Change in Glycemic Control - REACH Only vs. Control & REACH+FAMS vs. Control
3 months
9.12 percent
Standard Deviation 1.41
8.98 percent
Standard Deviation 1.61
9.47 percent
Standard Deviation 1.77
Change in Glycemic Control - REACH Only vs. Control & REACH+FAMS vs. Control
6 months
8.88 percent
Standard Deviation 1.64
9.14 percent
Standard Deviation 1.53
9.74 percent
Standard Deviation 2.37
Change in Glycemic Control - REACH Only vs. Control & REACH+FAMS vs. Control
12 months
9.45 percent
Standard Deviation 1.89
9.57 percent
Standard Deviation 2.19
9.67 percent
Standard Deviation 2.21
Change in Glycemic Control - REACH Only vs. Control & REACH+FAMS vs. Control
15 months
9.28 percent
Standard Deviation 1.97
9.41 percent
Standard Deviation 1.74
9.57 percent
Standard Deviation 2.25

Adverse Events

REACH

Serious events: 0 serious events
Other events: 0 other events
Deaths: 3 deaths

REACH + FAMS

Serious events: 0 serious events
Other events: 0 other events
Deaths: 2 deaths

Helpline and A1c Results

Serious events: 0 serious events
Other events: 0 other events
Deaths: 3 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Lindsay S. Mayberry, PhD, MS

Vanderbilt University Medical Center

Phone: 615-875-5821

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place