Development and Value of a Centralized Text Message-based Tracking and Support Program for the PRECIDENTD Study

PRECIDENTD (PRevention of CardIovascular and DiabEtic KidNey Disease in Type 2 Diabetes) is a PCORnet® Study evaluating 2 classes of medications, SGLT2 inhibitors and GLP-1 receptor agonists, among people with type 2 diabetes. Participants obtain their assigned medication through their health insurance and complete semi-annual study assessments.

We engaged multiple partners to develop a centralized text message-based program to facilitate adherence and retention in PRECIDENTD and evaluated its performance from April 2024 to April 2025.

The PRECIDENTD study team applied best practices in digital health tool design and built the program with technology company MEMOTEXT. Patient partners identified program goals, co-wrote message content, and completed internal testing. We then deployed the program to PRECIDENTD participants and analyzed responses.

We assessed response rate to interactive text messages, proportion of messages flagging participants needing additional support, and the adherence problems identified.

The text messaging program includes interactive messages querying if participants are taking the study medication, as well as one-way study timeline messages. During the first year, 450 PRECIDENTD participants across 20 sites received texts. Interactive message response rate was 80%, and 25% of responses identified problems (ie, trouble getting fills/refills and experiencing a health concern or side effect), prompting an outreach call.

We co-designed a digital tool that engaged participants and helped identify study participants needing assistance obtaining and adhering to study medications. Collaborative development of similar centralized tools may augment the capacity of national studies to answer important comparative effectiveness research questions.