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Diabetes Mellitus, Type 2NCT05101330

Impact of Bilingual Prescription Medication Labels Among Elderly Singaporeans

A study testing Bilingual prescription medication labels in people with Diabetes Mellitus, Type 2 and Hypertension, run by Singapore General Hospital at 1 site in Singapore.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The proposed study aims to provide preliminary data that will enable the conduct of a larger Randomized Controlled Trial (RCT) on the impact of bilingual Prescription Medication Labels (PMLs) on 3 medication-related outcomes - medication adherence, medication management self-efficacy, and PML understanding. Read more about this study

Who is it for?
Ages 50 years and older
Conditions the study is for
Diabetes Mellitus, Type 2, Hypertension
What is being tested?
Bilingual prescription medication labels
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteSingapore
Study dates
1 Nov 2021to 12 May 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Singapore citizen/permanent resident
  • Aged 50 years and above
  • Just received a new (i.e., not received before) oral medication for a chronic disease
  • No moderate/severe cognitive impairment (5 or more correct responses on the Abbreviated Mental Test, AMT)
  • Not deaf (self-reported)
  • No binocular presenting near vision impairment (near visual acuity, with routinely used spectacles/lenses: at least 6/15 (0.40 logMAR) on the Landolt's C chart)
Show all 9Show fewer
  • Able to speak at least 1 of the 4 official languages;
  • Unable to read in English but able to read another official language (as they will benefit the most from bilingual PMLs)
  • Assessed as non-adherent

Who cannot join

  • Patients who received, from the prescribing physician, a set of instructions for their new oral medication that does not match standard instructions (as the bilingual instructions for non-standard instructions would not be prepared for beforehand)

Trial locations and contacts

1 site in 1 country.

Singapore1 site
  • Singapore General Hospital

    Singapore, 169608

Other trials in Singapore

About this study

Official title: Impact of Bilingual Prescription Medication Labels on Medication Adherence and Medication Management Self-Efficacy Among Elderly Singaporeans: A Pilot Study

The proposed study aims to provide preliminary data that will enable the conduct of a larger Randomized Controlled Trial (RCT) on the impact of bilingual Prescription Medication Labels (PMLs) on 3 medication-related outcomes - medication adherence, medication management self-efficacy, and PML understanding.

Read the detailed description

The investigators will randomize 40 patients to Pilot Trial A or Pilot Trial B. Those in Pilot Trial A will be further randomized to Bilingual PMLs (intervention arm) or English PMLs (usual care arm) at 2 weeks post-recruitment, after assessing baseline level of the 3 medication-related outcomes; trial outcomes: difference in change, from baseline to 2 weeks post-randomization, in the 3 medication-related outcomes between the 2 arms. Those in Pilot Trial B will be further randomized to Bilingual PMLs or English PMLs immediately post-recruitment; trial outcomes: difference, at 2 weeks post-randomization, in the 3 medication-related outcomes between the 2 arms. This formative study will (1) assess the feasibility of administering the intervention, (2) refine protocols for study participant recruitment, engagement and retention, and (3) gain experience with and refine measurement of the outcomes for evaluating the intervention. The conduct of 2 pilot trials will allow us to choose the optimal trial design and determine variability.

Being tested
Bilingual prescription medication labels
Keywords
Medication adherence, Prescription Medication Labels, Bilingual prescription medication labels, Anti-diabetic drugs, Older adults, Medication management self-efficacy, Health literacy, Literacy, Anti-hypertensives, Glucose-lowering agent
Medical subject headings
Diabetes Mellitus, Type 2, Hypertension, Medication Adherence, Literacy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Bilingual prescription medication labelsDevice

    Also called PMLs

    The bilingual PML contains English and Chinese medication-related instructions for participants.

Study groups in NCT05101330
Study groupRoleWhat they receive
Pilot Trial A, Usual Care armNo interventionAt recruitment, participants will be dispensed with new medication provided together with PMLs in English. After 2 weeks, data will be collected during a home visit and no changes will be made to the PMLs. After another 2 weeks, data will be collected and Rx Cap pill bottles will be retrieved.
Pilot Trial A, Intervention armExperimentalAt recruitment, participants will be dispensed new medication in Rx Cap pill bottles provided with PMLs in English. After 2 weeks, a home visit will be conducted, where the English PMLs will be switched out with bilingual PMLs. A final home visit will be done after another 2 weeks, and the labels will be switched back to the standard-issue PMLs issued by SGH, and the Rx Cap pill bottles will be retrieved.
Receives: Device: Bilingual prescription medication labels
Pilot Trial B, Usual Care armNo interventionAt recruitment, participants will be dispensed new medication in Rx Cap pill bottles provided with PMLs in English. After 2 weeks, data will be collected and Rx Cap bottles will be retrieved.
Pilot Trial B, Intervention armExperimentalAt recruitment, participants will be dispensed new medication in Rx Cap pill bottles, provided with bilingual PMLs. After 2 weeks, data will be collected accordingly during the home visit and Rx Cap bottles will be retrieved. Bilingual labels will be removed and participants will resume usage of standard-issue SGH PMLs.
Receives: Device: Bilingual prescription medication labels

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Measuring change from Week 2 in Medication Adherence on the Adherence to Refills and Medications Scale (ARMS) at Week 4. (Pilot Trial A)

    ARMS is a validated self-reported medication-adherence scale intended for patients with chronic diseases.

    Its 12 questions consist of 2 subscales - adherence to refilling prescriptions and adherence with taking medications. Each item is structured using the Likert scale, with the following response options and corresponding scores: "none" (score of 1), "some" (score of 2), "most" (score of 3 ), or "all of the time" (score of 4). The range of possible total scores is 12 to 48. Lower scores indicate better adherence.

    Measured: Week 2 and Week 4 of Pilot Trial A

  2. Assessing Medication Adherence on the ARMS at Week 2. (Pilot Trial B)

    ARMS is a validated self-reported medication-adherence scale intended for patients with chronic diseases.

    Its 12 questions consist of 2 subscales - adherence to refilling prescriptions and adherence with taking medications. Each item is structured using the Likert scale, with the following response options and corresponding scores: "none" (score of 1), "some" (score of 2), "most" (score of 3 ), or "all of the time" (score of 4). The range of possible total scores is 12 to 48. Lower scores indicate better adherence.

    Measured: Week 2 of Pilot Trial B

  3. Measuring change from Week 2 in Medication Adherence using the MedTake Assessment at Week 4. (Pilot Trial A)

    MedTake Assessment is a self-reported measure for pharmacy staff when providing pharmaceutical care services, assessing patient adherence and knowledge to dose, dosage, indication, food or water co-ingestion, and regimen. A composite score (0-100%); higher ~ better) summarizes patient's ability to take medicine safely.

    Measured: Week 2 and Week 4 of Pilot Trial A

  4. Assessing Medication Adherence using the MedTake Assessment at Week 2 (Pilot Trial B)

    MedTake Assessment is a self-reported measure for pharmacy staff when providing pharmaceutical care services, assessing patient adherence and knowledge to dose, dosage, indication, food or water co-ingestion, and regimen. A composite score (0-100%); higher ~ better) summarizes patient's ability to take medicine safely.

    Measured: Week 2 of Pilot Trial B

  5. Measuring change from Week 2 in Medication Adherence via Pill Count at Week 4. (Pilot Trial A)

    A pill count, in context of the new oral medication, will be done. % adherence = ((quantity dispensed)-(quantity remaining))/ ((prescribed number of pills per day) x (no. of days between dispensing date and interview))

    Measured: Week 2 and Week 4 of Pilot Trial A

  6. Assessing Medication Adherence via Pill Count at Week 2. (Pilot Trial B)

    A pill count, in context of the new oral medication, will be done. % adherence = ((quantity dispensed)-(quantity remaining))/ ((prescribed number of pills per day) x (no. of days between dispensing date and interview))

    Measured: Week 2 of Pilot Trial B

  7. Measuring change from Week 2 in Medication Adherence based on Rx Cap openings at Week 4. (Pilot Trial A)

    The Rx Cap Bluetooth smart cap automatically tracks medication usage every time it is opened. The data collected and stored within the Smart Cap will be imported at home visits with participants. Continuous (% adherence to prescribed regimen; 0-100%) and categorical variables (not at all; partially; fully) for medication adherence will be derived.

    Measured: Week 2 and Week 4 of Pilot Trial A

  8. Assessing Medication Adherence based on Rx Cap openings at Week 2. (Pilot Trial B)

    The Rx Cap Bluetooth smart cap automatically tracks medication usage every time it is opened. The data collected and stored within the Smart Cap will be imported at home visits with participants. Continuous (% adherence to prescribed regimen; 0-100%) and categorical variables (not at all; partially; fully) for medication adherence will be derived.

    Measured: Week 2 of Pilot Trial B

  9. Measuring change from Week 2 in Medication management self-efficacy on the MUSE Scale at Week 4. (Pilot Trial A)

    The 8-item Medication Understanding and Use Self-Efficacy Scale (MUSE), comprises of 2 subscales: (1) taking medication (4 items), and (2) learning about medication (4 items). Item scores (four-point Likert scale; strongly disagree (score 1), to, strongly agree (score=4)) will be summed for subscale (range: 4-16) and total scores (range: 8-32; higher score ~ greater level of medication management self-efficacy).

    Measured: Week 2 and Week 4 of Pilot Trial A

  10. Measuring Medication management self-efficacy on the MUSE Scale at Week 2 (Pilot Trial B)

    The 8-item Medication Understanding and Use Self-Efficacy Scale (MUSE), comprises of 2 subscales: (1) taking medication (4 items), and (2) learning about medication (4 items). Item scores (four-point Likert scale; strongly disagree (score 1), to, strongly agree (score=4)) will be summed for subscale (range: 4-16) and total scores (range: 8-32; higher score ~ greater level of medication management self-efficacy).

    Measured: Week 2 of Pilot Trial B

  11. Measuring change from Week 2 in PML understanding at Week 4. (Pilot Trial A)

    Respondents will be asked tailored questions (in their preferred language) specific to the instructions presented on their PML for the new oral medication.

    Measured: Week 2 and Week 4 of Pilot Trial A

  12. Assessing PML understanding at Week 2. (Pilot Trial B)

    Respondents will be asked tailored questions (in their preferred language) specific to the instructions presented on their PML for the new oral medication.

    Measured: Week 2 of Pilot Trial B

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Nov 2021
  2. Study start1 Nov 2021 (estimated)
  3. Primary completion12 May 2022
  4. Study completion12 May 2022 (estimated)

Why it stopped: Recruitment was challenging, and no participants were recruited after 6 months despite minimizing these challenges. Therefore the study team has decided not to pursue this study any further.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
We will recruit 40 patients who have just been given a new oral medication for a chronic disease. They will then be randomized (1:1) to either Pilot Trial A or Pilot Trial B. There will be 2 pilot versions of a 2-arm parallel-group RCT.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05101330
Sponsor's protocol ID
1
Status last verified
May 2022
First submitted
29 Mar 2021
Last updated
24 May 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Malhotra R, Bautista MAC, Muller AM, Aw S, Koh GCH, Theng YL, Hoskins SJ, Wong CH, Miao C, Lim WS, Malhotra C, Chan A. The Aging of a Young Nation: Population Aging in Singapore. Gerontologist. 2019 May 17;59(3):401-410. doi: 10.1093/geront/gny160.

    PubMed 30517628
  • Malhotra R, Bautista MAC, Tan NC, Tang WE, Tay S, Tan ASL, Pouliot A, Saffari SE, Chei CL, Vaillancourt R. Bilingual Text With or Without Pictograms Improves Elderly Singaporeans' Understanding of Prescription Medication Labels. Gerontologist. 2019 Mar 14;59(2):378-390. doi: 10.1093/geront/gnx169.

    PubMed 29190378

Questions about this trial

What is this clinical trial studying?

A study testing Bilingual prescription medication labels in people with Diabetes Mellitus, Type 2 and Hypertension, run by Singapore General Hospital at 1 site in Singapore.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 24 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Measuring change from Week 2 in Medication Adherence on the Adherence to Refills and Medications Scale (ARMS) at Week 4. (Pilot Trial A) (time frame: Week 2 and Week 4 of Pilot Trial A). The study lists 12 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05101330, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 May 2022.

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