Comparative Effectiveness, 2010
Researchers from the Knowledge and Encounter Research Unit at the Mayo Clinic in Minnesota used AHRQ's Comparative Effectiveness Review "Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults With Type 2 Diabetes" to develop a patient decision aid that helps patients decide what type of medication is right for them. The decision aid was used in a study of diabetes medication choices to determine whether increased patient involvement in medication decisions would increase medication adherence and create greater glycemic control.
Mayo researcher Nilay Shah, MD, PhD, says, "The [AHRQ] evidence report was helpful in summarizing the literature and provided a very high-level summary, as well as details."
Developed with the information from the AHRQ review, the decision aid consists of six Diabetes Medication Cards. The cards outline different treatment options, how each of those treatments is taken, what their side effects are, and how they affect daily routine and blood-sugar testing. Shah notes, "There wasn't anything like [the decision aid] out there. We believe it helps patients get involved in the decisionmaking related to their medications."
The Mayo study found that patients often look at only two or three attributes of a diabetes treatment before making a decision. Patients were most commonly concerned with weight gain, daily sugar testing, and impact on daily routine. In the pilot trial, the patients showed a lower preference for using information about side effects or A1C reduction when choosing treatment options relative to the other attributes. The study took place over 6 months and included 85 patients, 48 of whom used the decision aid. The decision aid can be seen at http://kercards.e-bm.info.
Shah and colleagues are in the process of expanding the study to 20 other clinics to determine how to integrate the decision aid into daily practice. They will also investigate whether using the decision aid causes patients to control their blood sugar better over the long run.
The Comparative Effectiveness Review was prepared for AHRQ by the Johns Hopkins Evidence-based Practice Center under Contract No. 290-02-0018.
Impact Case Study Identifier: COE-10-01
AHRQ Product: Effective Health Care Program
Topic(s): Chronic Disease Management, Diabetes
Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults With Type 2 Diabetes, July 2007. Executive Summary No. 8. AHRQ Publication No. 07-EHC010-1. Agency for Healthcare Research and Quality, Rockville, MD.
Mullan RJ, Montori VM, Shah ND, et al. The diabetes medication choice decision aid: a randomized trial. Arch Intern Med 2009;169:1560-8.
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