Behavior change techniques to improve treatment adherence in type 2 diabetes: A systematic review.

INTRODUCTION: Cognitive-behavioral interventions have shown positive results in type 2 diabetes mellitus (T2DM) self-management; however, the lack of detailed descriptions of these interventions makes their replication difficult. This study aims to identify behavioral change techniques (BCT) for improving adherence to medication, diet, and exercise in adults with T2DM. METHOD: We conducted a systematic search in June 2024 across PubMed, Cochrane, Web of Science, PsycINFO, and CINAHL to identify studies published since 2013 that examined BCTs aimed at improving treatment adherence in adults with T2DM. RESULTS: A total of 6 articles - including randomized controlled trials, a scoping review, and systematic reviews - were included, addressing adherence to medication, diet, and exercise. BCTs associated with improved adherence and reported across multiple studies included action planning (1.4), social support (unspecified) (3.1), social support (practical) (3.2), instruction on how to perform a behavior (4.1), information about health consequences (5.1), prompts and cues (7.1), and credible source (9.1). CONCLUSIONS: The findings highlight the importance of clearly structured intervention descriptions and the use of robust theoretical frameworks. Future interventions should incorporate components targeting patient education, skill development, and support networks to enhance adherence to dietary recommendations, physical activity, and pharmacological treatment.