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The impact of decision aids to enhance shared decision making for diabetes (the DAD study): protocol of a cluster randomized trial

The impact of decision aids to enhance shared decision making for diabetes (the DAD study): protocol of a cluster randomized trial
The impact of decision aids to enhance shared decision making for diabetes (the DAD study): protocol of a cluster randomized trial
Background. Shared decision making contributes to high quality healthcare by promoting a patientcentered approach. Patient involvement in selecting the components of a diabetes medication program that best match the patient's values and preferences may also enhance medication adherence and improve outcomes. Decision aids are tools designed to involve patients in shared decision making, but their adoption in practice has been limited. In this study, we propose to obtain a preliminary estimate of the impact of patient decision aids vs. usual care on measures of patient involvement in decision making, diabetes care processes, medication adherence, glycemic and cardiovascular risk factor control, and resource utilization. In addition, we propose to identify, describe, and explain factors that promote or inhibit the routine embedding of decision aids in practice.

Methods. We will be conducting a mixed-methods study comprised of a cluster-randomized, practical, multicentered trial enrolling clinicians and their patients (n = 240) with type 2 diabetes from rural and suburban primary care practices (n = 8), with an embedded qualitative study to examine factors that influence the incorporation of decision aids into routine practice. The intervention will consist of the use of a decision aid (Statin Choice and Aspirin Choice, or Diabetes Medication Choice) during the clinical encounter. The qualitative study will include analysis of video recordings of clinical encounters and in-depth, semi-structured interviews with participating patients, clinicians, and clinic support staff, in both trial arms.

Discussion. Upon completion of this trial, we will have new knowledge about the effectiveness of diabetes decision aids in these practices. We will also better understand the factors that promote or inhibit the successful implementation and normalization of medication choice decision aids in the care of chronic patients in primary care practices.
diabetes, shared decision making, cardiovascular prevention, implementation
1472-6963
130
LeBlanc, Annie
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Ruud, Kari L.
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Branda, Megan E.
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Tiedje, Kristina
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Boehmer, Kasey R.
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Pencille, Laurie J.
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Van Houten, Holly
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Matthews, Marc
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Shah, Nilay D.
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May, Carl R.
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Yawn, Barbara P.
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Montori, Victor M.
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LeBlanc, Annie
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Ruud, Kari L.
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Branda, Megan E.
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Tiedje, Kristina
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Boehmer, Kasey R.
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Pencille, Laurie J.
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Van Houten, Holly
f1c6b35b-7c1c-4626-b545-f756f9e3b9ab
Matthews, Marc
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Shah, Nilay D.
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May, Carl R.
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Yawn, Barbara P.
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Montori, Victor M.
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LeBlanc, Annie, Ruud, Kari L., Branda, Megan E., Tiedje, Kristina, Boehmer, Kasey R., Pencille, Laurie J., Van Houten, Holly, Matthews, Marc, Shah, Nilay D., May, Carl R., Yawn, Barbara P. and Montori, Victor M. (2012) The impact of decision aids to enhance shared decision making for diabetes (the DAD study): protocol of a cluster randomized trial. BMC Health Services Research, 12, 130. (doi:10.1186/1472-6963-12-130). (PMID:22640439)

Record type: Article

Abstract

Background. Shared decision making contributes to high quality healthcare by promoting a patientcentered approach. Patient involvement in selecting the components of a diabetes medication program that best match the patient's values and preferences may also enhance medication adherence and improve outcomes. Decision aids are tools designed to involve patients in shared decision making, but their adoption in practice has been limited. In this study, we propose to obtain a preliminary estimate of the impact of patient decision aids vs. usual care on measures of patient involvement in decision making, diabetes care processes, medication adherence, glycemic and cardiovascular risk factor control, and resource utilization. In addition, we propose to identify, describe, and explain factors that promote or inhibit the routine embedding of decision aids in practice.

Methods. We will be conducting a mixed-methods study comprised of a cluster-randomized, practical, multicentered trial enrolling clinicians and their patients (n = 240) with type 2 diabetes from rural and suburban primary care practices (n = 8), with an embedded qualitative study to examine factors that influence the incorporation of decision aids into routine practice. The intervention will consist of the use of a decision aid (Statin Choice and Aspirin Choice, or Diabetes Medication Choice) during the clinical encounter. The qualitative study will include analysis of video recordings of clinical encounters and in-depth, semi-structured interviews with participating patients, clinicians, and clinic support staff, in both trial arms.

Discussion. Upon completion of this trial, we will have new knowledge about the effectiveness of diabetes decision aids in these practices. We will also better understand the factors that promote or inhibit the successful implementation and normalization of medication choice decision aids in the care of chronic patients in primary care practices.

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e-pub ahead of print date: 28 May 2012
Published date: May 2012
Keywords: diabetes, shared decision making, cardiovascular prevention, implementation
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 340855
URI: http://eprints.soton.ac.uk/id/eprint/340855
ISSN: 1472-6963
PURE UUID: 1f7cc6fd-3f60-4ccb-bdd5-326149d86f35
ORCID for Carl R. May: ORCID iD orcid.org/0000-0002-0451-2690

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Date deposited: 04 Jul 2012 12:08
Last modified: 14 Mar 2024 11:30

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Contributors

Author: Annie LeBlanc
Author: Kari L. Ruud
Author: Megan E. Branda
Author: Kristina Tiedje
Author: Kasey R. Boehmer
Author: Laurie J. Pencille
Author: Holly Van Houten
Author: Marc Matthews
Author: Nilay D. Shah
Author: Carl R. May ORCID iD
Author: Barbara P. Yawn
Author: Victor M. Montori

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