[2026-09-15] Effectiveness of a Mobile Application in Promoting Medication Adherence Among Patients With Type 2 Diabetes in a Thai Primary Care Setting: A Randomized Controlled Trial
DOI:
https://doi.org/10.33165/rmj.2027.e281174Keywords:
Mobile application, Medication adherence, Type 2 diabetesAbstract
Background: Medication adherence is an important factor influencing glycemic control in patients with type 2 diabetes mellitus (T2DM). While mobile health applications have been developed to support self-management, research on medication reminder apps for patients with diabetes in Thailand remains limited.
Objective: To evaluate the effectiveness of a medication reminder mobile application on medication adherence compared with usual care in patients with T2DM.
Methods: A randomized controlled trial was conducted at the Family Medicine Outpatient Clinic, Ramathibodi Hospital. Adults aged ≥ 18 years with T2DM, hemoglobin A1c (HbA1c) ≥ 7% or fasting blood glucose (FBG) ≥ 130 mg/dL, and suboptimal adherence (Medication Adherence Scale in Thais [MAST] < 34) were enrolled. Participants were randomly assigned (1:1) to usual care or usual care plus a medication reminder application for 3 months. The primary outcome was the change in MAST score. Secondary outcomes included changes in FBG and HbA1c.
Results: Thirty-one participants were randomized (control, n = 16; intervention, n = 15). At baseline, medication adherence was significantly lower in the intervention group than in the control group (mean [SD] MAST score, 27.07 [4.82] vs 30.06 [2.46]; P = .042). After 3 months, the intervention group demonstrated a greater unadjusted improvement in MAST score (mean [SD] change, 6.87 [4.58] vs 2.69 [4.14]; between-group difference, 4.18 points; P = .012). However, after adjustment for baseline adherence using analysis of covariance, the between-group difference was no longer statistically significant (adjusted mean difference, 2.04 points; 95% CI, -0.73 to 4.80; P = .143). No statistically significant between-group differences were observed in FBG or HbA1c.
Conclusions: The medication reminder application was associated with improved medication adherence among patients with T2DM; however, the between-group difference was not statistically significant after adjustment for baseline adherence. No significant improvements in glycemic outcomes were observed during the 3-month follow-up. These preliminary findings require confirmation in a larger, adequately powered randomized controlled trial.
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