Text-message reminders plus incentives increase adherence to antidiabetic medication in adults with type 2 diabetes
A quick text plus pocket change reliably helps adults with diabetes take their medicine on time.
01Research in Context
What this study did
Three adults with Type 2 diabetes got daily text reminders to take their pills.
Each time they replied "taken" they earned a small cash reward.
The researchers tracked pill taking across several baseline and treatment phases.
What they found
All three adults took more pills once texts plus money started.
Adherence stayed high as long as the incentives stayed in place.
How this fits with other research
McConkey et al. (2010) used online vouchers to double blood-glucose testing in teens. Both studies show token economies work for diabetes care, just with different tools.
Azrin et al. (1969) built a mechanical pill box that buzzed until the user turned a knob and took a tablet. Raiff et al. (2016) swaps the knob for a phone and adds money—same reinforcement logic, newer tech.
McGonigle et al. (2014) sent PDA prompts to adults with bipolar disorder but offered no reward. Their adherence rose only a little, hinting that prompts alone are weaker than prompts plus pay.
Why it matters
If a client forgets daily meds, pair a simple text prompt with a tiny incentive—even a dollar. Start during a baseline week, then roll it out full-time. Track replies; fade the money slowly once habits stick.
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02At a glance
03Original abstract
Some adults with Type 2 diabetes mellitus have difficulty adhering to their oral medication regimens. The current study used a multiple baseline design with 3 adults with Type 2 diabetes. Medication taking was monitored remotely in real time via an electronic pill bottle. During the intervention, monetary incentives were delivered contingent on evidence of adherence to taking medication at specified times. Text-message reminders were also sent if medication was not taken. Adherence increased for all participants. Future studies should separate the relative contributions of text-message and incentive components of the intervention.
Journal of Applied Behavior Analysis, 2016 · doi:10.1002/jaba.337