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Imagine to Remember: Improving Medication Adherence in Pre- and Type 2 Diabetes

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT04157673
Recruitment Status : Recruiting
First Posted : November 8, 2019
Last Update Posted : November 15, 2019
Information provided by (Responsible Party):
Leonard Epstein, State University of New York at Buffalo

Brief Summary:
Determine if a 6-week intervention consisting of future-thinking improves different facets of memory/executive function and/or decision-making.

Condition or disease Intervention/treatment Phase
Medication Adherence Behavioral: Episodic Future Thinking Not Applicable

Detailed Description:
The aim of this study is to determine if a cognitive intervention is an efficacious method for improving medication adherence in adults with prediabetes or type 2 diabetes. Participants in this study will complete assessment sessions, as well as intervention sessions over a 3-month period. During this time, medication adherence will be monitored using a MEMS cap. The investigators hypothesize that, following the cognitive intervention, there will be improvements in participants' medication adherence, as well as in facets of memory.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: This study is an experimental between-subjects design; participants will be randomized to Episodic Future Thinking (EFT) or a health informational control group (IC).
Masking: Single (Participant)
Masking Description: Participants will not be informed of the group that they are randomly assigned until the completion of the study.
Primary Purpose: Treatment
Official Title: Imagine to Remember: Improving Medication Adherence in Pre- and Type 2 Diabetes
Actual Study Start Date : September 1, 2019
Estimated Primary Completion Date : May 1, 2020
Estimated Study Completion Date : May 1, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Memory

Arm Intervention/treatment
Experimental: Episodic Future Thinking
The intervention being researched is called episodic future thinking (EFT), which consists of imagining specific instances of one's future. In this study, participants will engage in EFT focused on imagining taking one's medication, guided by a research staff member in their intervention sessions in addition to weekly check-in calls across a 6-week period. The research staff member will conduct the intervention session using a semi-structured interview format in which they work to identify situations in which the participant encounters challenges with taking their medication and will ask questions to prompt the participant to imagine what successful medication adherence would consist of. Sessions may also involve imagining positive events resulting from successful medication adherence and the details surrounding those events.
Behavioral: Episodic Future Thinking
This intervention involves participants engaging in episodic future thinking in order to improve their medication adherence and overall prospective thinking ability.

Active Comparator: Information Control Group
The control group is called the information control group (IC), which consists of participants learning information relating to pre-diabetes or type 2 diabetes, and then generating sentences about this information, describing what they found useful or interesting about it. These sentences mirror the experience of engaging in episodic future thinking, except they lack the prospective and episodic components.
Behavioral: Episodic Future Thinking
This intervention involves participants engaging in episodic future thinking in order to improve their medication adherence and overall prospective thinking ability.

Primary Outcome Measures :
  1. Medication Adherence [ Time Frame: 3 months ]
    The investigators will measure medication adherence through MEMS and pill count data

  2. Prospective memory [ Time Frame: 3 months ]
    Prospective memory ability will be assessed through a computer-based prospective memory task

Secondary Outcome Measures :
  1. Delay Discounting [ Time Frame: 3 months ]
    Participants' impulsivity will be assessed through a computer-based decision-making task

  2. Working Memory [ Time Frame: 3 months ]
    Working memory will be assessed through a brief computer-based task

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

Adults over the age of 18 with prediabetes or Type 2 Diabetes currently prescribed at least one oral medication for blood glucose regulation, or for related comorbidities e.g., hypertension, hyperlipidemia, and are relatively non-adherent to taking them (< 80% of prescribed doses taken), but are motivated and/or have the intent to better comply with their medication regimen, will be studied.

Prediabetes and Type 2 Diabetes: Participants must have a diagnosis of prediabetes or Type 2 Diabetes within the last 2 years or meet criteria for prediabetes or Type 2 Diabetes. The American Diabetes Association guidelines (Group, 2003) defines prediabetes and Type 2 Diabetes as Fasting Plasma Glucose (FPG) 100mg/dl or greater, 2h glucose 140mg/dl or greater after Oral Glucose Tolerance Test (OGTT), or hemoglobin A1c (HbA1c) of approximately 5.4% or greater.

Exclusion Criteria:

Pregnancy: Women who are pregnant or lactating will be excluded from participation.

Substance use, abuse, or dependence: Individuals that currently have problems with substance dependence, addiction, or problematic substance use that would limit participation (e.g., binge drinkers, alcoholics, daily stimulant/opiate users) will be excluded.

Conditions that affect adherence: Participants should not have a condition that would limit participation which include medical conditions that would affect individuals' ability to use the computer for prolonged period of time; leave the individual unable to ambulate; unmanaged psychiatric disorder (e.g., depression, anxiety, attention deficit hyperactivity disorder, schizophrenia), cognitive impairment that would impact memory (e.g., symptomatic concussion), or an intellectual impairment that would impact study adherence. Additionally, participants should be able to attend to all intervention sessions. If a participant is not able to make most sessions (e.g. participant is out of town during most of the study for work or vacation travel), they may be excluded from the study Prior participation in similar studies: Individuals who have recently participated in a laboratory study using similar methods may also be excluded.

Use of medication adherence aids: individuals who currently use aids to assist with medication adherence (e.g., pill organizers, reminder apps)may be excluded

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04157673

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United States, New York
University at Buffalo, Department of Pediatrics, Division of Behavioral Medicine Recruiting
Buffalo, New York, United States, 14214
Contact: Tatiana Jimenez-Knight    716-829-6122   
Principal Investigator: Leonard H Epstein, Ph.D.         
Sponsors and Collaborators
State University of New York at Buffalo

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Responsible Party: Leonard Epstein, SUNY Distinguished Professor and Division Chief, Behavioral Medicine, State University of New York at Buffalo Identifier: NCT04157673    
Other Study ID Numbers: FWA00008824
First Posted: November 8, 2019    Key Record Dates
Last Update Posted: November 15, 2019
Last Verified: November 2019

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No