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Imagine to Remember: An Episodic Future Thinking Intervention to Improve Medication Adherence in Patients with Type 2
Leonard H Epstein1, Tatiana Jimenez-Knight1, Anna M Honan1
1Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
Purpose:
Medication nonadherence is prevalent in diabetic populations, with "forgetting" a commonly cited reason. This issue of forgetfulness is due, in part, to a failure of prospective memory (PM). Episodic future thinking (EFT) has been shown to improve PM but has not been used to improve medication adherence.
Patients And Methods:
The current study used a multiple baseline design (N = 4) to test the effects of EFT on medication non-adherence for four patients with a diagnosis of type 2 diabetes or prediabetes, with comorbid high blood pressure or high cholesterol. Medication adherence was objectively measured over 15 weeks using medication event monitoring systems.
Results:
Results of visual analysis showed medication adherence was reliably improved, confirmed by mixed model analysis of variance (p < 0.001), with significant differences from baseline to treatment (Tau <0.05) for 3 of 4 participants. Improvements in two measures of PM (effect size (ES) = 0.73, 0.80) and delay discounting (ES = 1.20) were observed.
Conclusion:
This study provides a feasible way to improve medication adherence in patients with prediabetes or type 2 diabetes.
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