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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
1Health Sciences and Education, University of Hamburg, Hamburg, Germany.
BMJ Open
|December 16, 2018
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.
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.
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