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