Changing Patients’ Treatment Preferences and Values with a Decision Aid for Type 2 Diabetes Mellitus: Results from the Treatment Arm of a Randomized Controlled Trial
| Autor: | Martha M. Funnell, Qing Harshaw, Nananda F. Col, Robert A. Bailey, Jeffrey VanWingen, Alicia C. Shillington |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Hypoglycemia law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Values clarification law Diabetes mellitus Internal medicine Type 2 diabetes mellitus Internal Medicine Medicine 030212 general & internal medicine Dosing Shared decision-making Original Research business.industry Type 2 Diabetes Mellitus Antihyperglycemic medication medicine.disease Patient values Patient decision aid Regimen medicine.symptom business Weight gain Treatment Arm |
| Zdroj: | Diabetes Therapy |
| ISSN: | 1869-6961 1869-6953 |
| DOI: | 10.1007/s13300-018-0391-7 |
| Popis: | Introduction Failure to intensify treatment for type 2 diabetes mellitus (T2DM) when indicated, or clinical inertia, is a major obstacle to achieving optimal glucose control. This study investigates the impact of a values-focused patient decision aid (PDA) for T2DM antihyperglycemic agent intensification on patient values related to domains important in decision-making and preferred treatments. Methods Patients with poorly controlled T2DM who were taking a metformin-containing regimen were recruited through physicians to access a PDA presenting evidence-based information on T2DM and antihyperglycemic agent class options. Participants’ preferences for treatment, decision-making, and the relative importance they placed on various values related to treatment options (e.g., dosing, weight gain, side effects) were assessed before and after interacting with the PDA. Changes from baseline were calculated (post-PDA minus pre-PDA difference) and assessed in univariate generalized linear models exploring associations with patients’ personal values. Results Analyses included 114 diverse patients from 27 clinics across the US. The importance of avoiding injections, concern about hypoglycemia, and taking medications only once a day significantly decreased after interacting with the PDA [− 1.1 (p = 0.002), − 1.3 (p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|