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Informed shared decision-making programme for patients with type 2 diabetes in primary care: cluster randomised

Susanne Buhse1, Nadine Kuniss2,3, Kathrin Liethmann1,4

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Summary

This study successfully translated an informed shared decision-making programme (ISDM-P) for type 2 diabetes patients into primary care settings. While medication adherence remained high, the ISDM-P significantly improved informed choices and risk knowledge.

Keywords:
decision support techniquesdiabetes mellitus, Type 2health educatorshealth knowledge, attitudes, practicepatient education as topicprimary care

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Area of Science:

  • Diabetes management
  • Primary care research
  • Shared decision-making

Background:

  • Translating specialized diabetes care programs to primary care is crucial for broader patient access.
  • Informed shared decision-making programmes (ISDM-P) aim to improve patient engagement and outcomes.

Purpose of the Study:

  • To adapt and implement an ISDM-P for type 2 diabetes patients within a primary care setting.
  • To evaluate the effectiveness of the translated ISDM-P compared to standard care.

Main Methods:

  • A patient-blinded, two-arm, multicentre, cluster randomised controlled trial was conducted.
  • 279 patients with type 2 diabetes from 22 general practices participated.
  • The intervention group received the ISDM-P, including a decision aid and structured encounters; the control group received standard care.

Main Results:

  • No significant difference in drug adherence (antihypertensive or statin) was observed between groups.
  • ISDM-P participants showed significantly higher rates of informed choices regarding statin intake, blood pressure control, and glycated haemoglobin.
  • Risk knowledge scores and patient-physician agreement on treatment goals were notably higher in the ISDM-P group.

Conclusions:

  • The ISDM-P was successfully implemented in general practices.
  • High baseline medication adherence limited the detection of improvements in this specific outcome.
  • The ISDM-P demonstrated significant benefits in enhancing informed decision-making and risk understanding for type 2 diabetes patients in primary care.