[Effectiveness and Ethical Evaluation of Nudging to Promote the Self-Management in Diabetes Mellitus Type 2].

Autor:	Rauprich O; Institut für Ethik, Geschichte und Theorie der Medizin, Ludwig-Maximilians-Universität München, München, Germany., Möllenkamp M; Lehrstuhl für Management im Gesundheitswesen, Hamburg Center for Health Economics, Universität Hamburg, Hamburg, Germany., Reimann J; Institut für Sozial- und Gesundheitsrecht, Ruhr-Universitat Bochum, Bochum, Germany., Huster S; Institut für Sozial- und Gesundheitsrecht, Ruhr-Universitat Bochum, Bochum, Germany., Schreyögg J; Lehrstuhl für Management im Gesundheitswesen, Hamburg Center for Health Economics, Universität Hamburg, Hamburg, Germany., Marckmann G; Institut für Ethik, Geschichte und Theorie der Medizin, Ludwig-Maximilians-Universität München, München, Germany.
Jazyk:	němčina
Zdroj:	Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) [Gesundheitswesen] 2022 Nov; Vol. 84 (11), pp. 1059-1066. Date of Electronic Publication: 2022 Jun 23.
DOI:	10.1055/a-1709-0591
Abstrakt:	Background: Nudges offer a wide range of options for protecting health in everyday life that supplements traditional public health measures. Against this background, we conducted initial investigations on the effectiveness and ethical aspects of different nudges for promoting self-management of patients with diabetes mellitus type 2 in the context of Disease Management Programs (DMPs). Methods: The ethical assessment of the nudges was done within the systematic framework of Marckmann et al. (2015) for public health ethics. The existing evidence on the effectiveness of nudges was summarised by means of a narrative literature review. Results: Target agreements with implementation plans, reminder, feedback reports, shared appointments of patients with physicians, peer mentoring, and behavior contracts are nudging interventions with moderate interference with personal rights and relatively unproblematic ethical requirements, which have demonstrated effectiveness in different contexts. Default enrollment for patient training courses, involvement of partners, confrontation with social norms, and shocking pictures may be effective as well; however, they interfere more deeply with the freedom and privacy of patients and, therefore, are bound to stronger ethical requirements and restrictions. The evidence base is still insufficient, especially for social support measures by relatives and peers. Conclusions: Nudging offers a wide range of targeted interventions for supporting self-management of patients with chronic diseases, the potential of which has not yet been fully realized. Particularly promising interventions should be tested in pilot studies for their acceptance, effectiveness and cost-effectiveness in the context of DMPs. Competing Interests: Die Autorinnen/Autoren geben an, in keinem Interessenkonflikt zu stehen. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
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