Lack of accessible education on managing side effects combined with limited provider time and pharmacy closures drives low treatment adherence. Medication discontinuation in rural diabetes patients leads to poor health outcomes and increased complications.

• Rural diabetes patients experiencing side effects (e.g., headaches, infections, GI issues, weight gain)
• Patients and caregivers with low health literacy
• Providers with limited time to monitor adherence and educate patients

In rural Georgia, many patients begin new diabetes medications during brief primary care visits where education about potential side effects is often limited or rushed. As a result, patients frequently start drugs like Jardiance or Ozempic without fully understanding that side effects—such as headaches, gastrointestinal discomfort, or infections—can be expected and manageable. Patients also face challenges such as managing complex medication schedules while monitoring blood sugar and dealing with limited pharmacy access, particularly as independent pharmacies close due to low reimbursement rates from pharmacy benefit managers. Without clear guidance or follow-up support, these challenges often feel overwhelming or alarming, leading patients to discontinue medications prematurely.

Education around medication management is fragmented, with unclear roles between providers and pharmacists. Community health workers help bridge this gap by producing informational materials, but these are often unstandardized due to regulatory constraints.

Efforts by providers to track medication pickup by contacting pharmacies are often inconsistent and hindered by limited time and resources, making it difficult to ensure reliable follow-up. Solutions like QR codes on medication handouts or recommending YouTube videos fall short because they rely on patients having digital access and the motivation to seek out the information, which is often lacking in rural populations with low health literacy. Similarly, adherence aids like bubble packs are underutilized.

NEEDS STATEMENT:

1.Develop and implement culturally concordant, easy-to-understand learning tools delivered through trusted local channels—such as community health workers and printed materials—to reduce medication discontinuation from side effects among rural diabetes patients, especially those with low health literacy and limited digital access.

2.Enable rural providers to track medication adherence, receive real-time alerts, and identify high-risk patients, facilitating timely outreach and care coordination without increasing provider workload.

REQUIREMENTS:

• Use simple, jargon-free language with clear visuals to explain medication side effects and management strategies.
• Implement a user-friendly adherence tracking system integrated with existing clinical workflows and electronic health records.
• Implement a user-friendly adherence tracking system integrated with existing clinical workflows and electronic health records.
• Minimize additional workload on providers by automating data collection and alert generation wherever possible.

ADDITIONAL CONSIDERATIONS:

How can providers and pharmacists accurately assess what patients understand about their medications?

Explore the role of motivational interviewing in helping patients troubleshoot issues.

Consider low-bandwidth or non-digital tools, such as personalized medication summaries with 3 key points printed on boxes.