Rebecca J. Mullan|Víctor M. Montori|Nilay D. Shah|Teresa Christianson|Sandra C. Bryant|Gordon Guyatt|Lilisbeth Perestelo?Pérez|Robert J. Stroebel|Barbara P. Yawn|Victor Yapuncich|Maggie Breslin|Laurie Pencille|Steven A. Smith
The Diabetes Mellitus Medication Choice Decision Aid
Mayo Clinic|Winneshiek Medical Center
patient involvement choice antihyperglycemic agents could improve adherence optimize glycemic control patients type 2 diabetes mellituswe conducted pilot cluster randomized trial diabetes medication choice decision aid describes 5 antihyperglycemic drugs treatment burden adverse effects administration selfmonitoring demands impact hemoglobin a1c hba1c levels twentyone clinicians randomized use decision aid clinical encounter 19 dispense usual care educational pamphlet used surveys video analysis assess postvisit decisional outcomes medical pharmacy records assess 6month medication adherence hba1c levelscompared usual care patients n 37 patients receiving decision aid n 48 found tool helpful clusteredadjusted mean difference amd 7point scale 038 95 confidence interval ci 004072 improved knowledge amd 110 10 questions 95 ci 011209 involvement making decisions diabetes medications amd 218 100 95 ci 130305 6month followup groups nearly perfect medication use median 100 days covered better adherence amd 9 days covered 95 ci 414 persistence amd 12 days covered 95 ci 321 days usual care group significant impact hba1c levels amd 001 95 ci 049 050an innovative decision aid effectively involved patients type 2 diabetes mellitus decisions medications improve adherence hba1c levels trial registration clinicaltrialsgov identifier nct00388050