Personalized Text Messaging for Type 2 Diabetes
(REINFORCE2 Trial)

Recruiting in Palo Alto (17 mi)

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Brigham and Women's Hospital

No Placebo Group

Trial Summary

What is the purpose of this trial?Reinforcement learning is an advanced analytic method that discovers each individual's pattern of responsiveness by observing their actions and then implements a personalized strategy to optimize individuals' behaviors using trial and error. The goal of the proposed research is to refine, adapt and perform efficacy testing of a novel reinforcement learning-based text messaging intervention to support medication adherence for patients with type 2 diabetes within a community health center setting. This study will be a parallel randomized pragmatic trial comparing medication adherence and clinical outcomes for adults in a community setting aged 18-84 with type 2 diabetes who are prescribed 1-3 daily oral medications for this disease. Participants will be randomized to one of two arms for the duration of the study period: (1) a reinforcement learning intervention arm with up to daily, tailored text messages based on time-varying treatment-response patterns; or (2) a control arm with up to daily, un-tailored text messages. Outcomes of interest will be medication adherence, as measured by electronic pill bottles, and HbA1c levels over 6 months.

Eligibility Criteria

This trial is for adults aged 18-84 with type 2 diabetes who have a recent HbA1c level of at least 7.5%, use a smartphone, understand English or Spanish, take 1-3 daily oral diabetes meds, and have been less than ideally consistent with their medication (PDC <0.80). It's not for those getting daily help with meds or unwilling to switch to electronic pill bottles.

Inclusion Criteria

Must have a basic working knowledge of English or Spanish

I have been diagnosed with Type 2 Diabetes.

I take 1 to 3 pills daily for my diabetes.

+3 more

Exclusion Criteria

Receive help at home on a daily basis with taking medications

Currently using a pillbox and/or not willing to use electronic pill bottles for 6 months

Participant Groups

The study tests if personalized text messages based on reinforcement learning can improve medication adherence in type 2 diabetes patients compared to standard texts. Participants will be randomly assigned to receive either tailored messages that adapt over time or generic ones, both potentially up to daily.

2Treatment groups

Experimental Treatment

Active Control

Group I: Reinforcement Learning Intervention ArmExperimental Treatment1 Intervention

Up to daily, tailored text messages.

Group II: Control ArmActive Control1 Intervention

Up to daily, untailored text messages.