What does this research mean for the field?

Among Spanish-speaking Latino adults with type 2 diabetes, modifiable barriers to medication adherence, particularly concerns about side effects and English-only instructions, are significantly more prevalent in patients with elevated HbA1c and low health literacy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to identify barriers affecting medication adherence among Latino adults with type 2 diabetes.

June 7, 2026

1554-P: Barriers to Treatment Adherence among Latino Adults with Type 2 Diabetes: Baseline Findings from the REACH-Es Pilot Study

Key Points

This research aims to identify barriers affecting medication adherence among Latino adults with type 2 diabetes.
Conducted a pilot randomized controlled trial (RCT) with 70 Latino adults over 6 months.
Collected demographic data, health literacy assessments (BRIEF), and HbA1c levels at enrollment.
Scored 18 identified barriers to medication adherence using a Likert scale and performed multivariable linear regression analysis.
Participants with HbA1c ≥9% reported higher barrier scores, indicating difficulties in prioritizing and understanding medication changes.
Barriers related to side effects and language issues were most significant, with longer effects on self-management.
Lower health literacy was strongly associated with the selection of specific health literacy-related barriers.

Abstract

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 (p0.05). 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. Disclosure 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. Funding NIH/NIDDK (K23DK135798)

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1554-P: Barriers to Treatment Adherence among Latino Adults with Type 2 Diabetes: Baseline Findings from the REACH-Es Pilot Study

Key Points

Abstract

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