Smartphone-based drug reminder app intervention to improve adherence in elderly diabetic patients: A community pilot study

Abstract

Background: Medication non-adherence it is a major issue in the management of diabetes in older adults, it 
will lead poor blood sugar control and there is a higher chance of developing complications. Digital health 
interventions show a potential for improving medication adherence in elderly patients with type 2 diabetes 
mellitus. Objective: The study investigated whether a smartphone-based medication reminder application could 
enhance medication adherence, glycemic control and health outcomes in elderly patients with type 2 diabetes 
mellitus in a community setting. Materials and Methods: A 6-month prospective randomized controlled trial 
was conducted with 120 elderly diabetic patients (aged ?65 years) recruited from three community health centers. 
Participants were randomly assigned to either the intervention group (n = 60), which received a customized 
smartphone medication reminder app with daily alerts and educational content, or the control group (n = 60), which 
received standard care. Primary outcomes included medication adherence (measured by the Morisky Medication 
Adherence Scale-8), glycated hemoglobin (HbA1c), fasting blood glucose (FBG), and postprandial blood glucose 
(PPBG). Secondary outcomes included blood pressure (BP), lipid profile, quality of life, diabetes self-management 
behaviors, and app usability. Assessments are conducted at baseline, 3–6 months. Results: Medication adherence 
scores received a higher ratingin the intervention group than in the control group at both 3 months (7.2 ± 0.8 vs. 
5.6 ± 1.2, P < 0.001) and t the 6-month follow-up, participants in the intervention group experienced significant 
reductions in HbA1c (7.1% vs. 8.0%), FBG (126.4 mg/dL vs. 156.2 mg/dL) and PPBG (168.2 mg/dL vs. 
209.8 mg/dL).The intervention group also achieved better BP control, improved lipid profiles, higher quality of 
life and greater satisfaction with managing their diabetes. A large majority of participants (82.3%) expressed a 
positive feedback about the app’s ease of use. Conclusion: The use of a smartphone-based medication reminder 
application led to substantial improvements in medication adherence and glycemic control among elderly diabetic 
individuals. This intervention is a practical, well-received and successful method for helping older adults manage 
their diabetes. Future studies should explore how to maintain the benefits and adapt the intervention to different 
healthcare environments.