[The "arriba Diabetes" decision aid - Results of a qualitative evaluation study]
Nicole Lindner1, Marie-Christine Hoffman1, Nobert-Donner Banzhoff1
1Institut für Allgemeinmedizin, Universität Marburg, Marburg, Deutschland.
Background:
Patient-centered therapy, with shared decision making (SDM) as a fundamental principle, is recommended in clinical guidelines for the care of individuals with type 2 diabetes mellitus but is often not implemented in practice. "arriba Diabetes" was developed as a decision aid to support shared decision-making (SDM) regarding therapy intensity. The underlying linear model requires four inputs: (1) age, (2) comorbidities, (3) preference preferences regarding treatment efforts, and (4) preferences regarding the avoidance of organ damage. Based on these inputs, the program calculates an appropriate therapy intensity. This study aimed to examine how GPs perceive "arriba Diabetes".
Methods:
This qualitative interview study aimed to explore general practitioners' (GPs') perceptions of "arriba Diabetes", specifically (1) whether the therapy intensity suggested by the model was considered appropriate, (2) whether the tool was perceived as comprehensible, and (3) whether it was regarded as complete. Interviews were conducted at two time points-before and after the application of the tool. The interview performed before the application followed the cognitive pretest approach. Data were analyzed thematically according to Braun and Clarke.
Results:
We conducted five interviews before and 18 interviews after the application of "arriba Diabetes". GPs generally perceived the recommended therapy intensity as appropriate. In some cases, it was initially regarded as not strict enough but, upon reflection, was considered comprehensible and even educational in terms of supporting de-escalation. The four input parameters (age, comorbidities, preference regarding treatment efforts, and preference regarding the avoidance of complications) were largely viewed as meaningful and complete, although the assessment of comorbidities and treatment efforts was sometimes described as challenging. Overall, GPs considered "arriba Diabetes" to be a practical and comprehensible tool for supporting SDM.
Conclusions:
"arriba Diabetes" has the potential to support shared decision-making on therapy intensity for individuals with type 2 diabetes mellitus.
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