Introduction and Objective: Suboptimal diabetes medication adherence disproportionately affects Latino adults with type 2 diabetes (T2D). REACH is a text messaging platform based on the Information-Motivation-Behavioral skills model that addresses barriers to medication adherence. REACH was adapted into Spanish (REACH-Español) and is being evaluated in a 6-month pilot RCT among 70 Latino adults with T2D. Here, we describe the distribution of participant-identified barriers to diabetes medication adherence at baseline and their associated characteristics.Methods: Demographic characteristics, health literacy assessment (BRIEF survey), and HbA1c were collected at enrollment. Participants also scored 18 barriers to diabetes medication adherence (Likert scale 1-10). We used descriptive statistics to characterize barrier score and multivariable linear regression to assess the relationship between HbA1c, health literacy, and barrier selection.Results: Barriers related to long-term side effects and English-only prescription instructions received the highest ratings. Participants with HbA1c ≥9% reported higher barrier scores than those with HbA1c <9%, including difficulty juggling priorities (38% vs 18%), understanding medication changes (43% vs 18%), and reading medication labels (43% vs 26%). Participants with low health literacy (BRIEF score ≤9) were more likely to select health-literacy-related barriers than those with higher health literacy, particularly barriers related to written medication instructions. Lower educational attainment, female sex, higher HbA1c, and shorter diabetes duration were associated with higher barrier ratings (p<0.05).Conclusion: Modifiable barriers to diabetes medication adherence were more frequently reported by Spanish-speaking patients with elevated HbA1c and low health literacy. Personalized interventions that can address patient-reported barriers to medication adherence may improve diabetes self-management in high-risk Latino populations.
A. Fremaint: None. R. Crespo Trevino: None. D. Wexler: Other – Data Monitoring Committee; Ended; Novo Nordisk. Other – Data Monitoring Committee; Current; Amgen Inc. L.S. Mayberry: None. J. Seiglie: None.
NIH/NIDDK (K23DK135798)
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