Patient Preference and Adherence (Jan 2022)
Imagine to Remember: An Episodic Future Thinking Intervention to Improve Medication Adherence in Patients with Type 2 Diabetes
Abstract
Leonard H Epstein,1 Tatiana Jimenez-Knight,1 Anna M Honan,1 Rocco A Paluch,1 Warren K Bickel2 1Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA; 2Addiction Recovery Research Center, Fralin Biomedical Research Center, Virginia Tech Carilion School of Medicine, Roanoke, VA, USACorrespondence: Leonard H EpsteinDepartment of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, G56, Farber Hall, Buffalo, NY, 14214, USATel +1 716-829-3400Email [email protected]: 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.Keywords: episodic future thinking, prediabetes, prospective memory, medication adherence
