Development of a patient decision aid for type 2 diabetes mellitus: a patient-centered approach.

IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL BMC primary care Pub Date : 2025-03-22 DOI:10.1186/s12875-025-02772-7
Anna Tichler, Dorijn F L Hertroijs, Dirk Ruwaard, Martijn C G J Brouwers, Arianne M J Elissen
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Abstract

Background: Patient decision aids (PDAs) can effectively facilitate shared decision-making (SDM) between patients and healthcare professionals. The International Patient Decision Aid Standards (IPDAS) Collaboration created a model for the systematic development of PDAs. However, the absence of a solid evidence base limits practical recommendations for best practices. For example, uncertainties exist about the most appropriate method for identifying the needs and preferences of patients and healthcare professionals. This study aims to detail the development process for the development of a PDA for type 2 diabetes mellitus (T2DM), using the IPDAS model.

Methods: From September 2020 to February 2023, we systematically developed the PDA for T2DM in the Netherlands. We adopted a patient-centered approach by researching patient considerations and actively collaborating with a multidisciplinary steering group, including patients with T2DM, patient organizations, and healthcare professionals. The PDA content and prototype development were determined by incorporating patients' needs and preferences, input from the steering group, and available evidence regarding T2DM treatment options. The research team and steering group iteratively reviewed the PDA prototype.

Results: A web-based PDA was developed consisting of five sections: 1) information about T2DM and the available treatment options; 2) comparison of treatment options; 3) questions to assess patients' knowledge; 4) value-clarification exercise; and 5) summary of the patient's journey through the PDA. Before patients use the PDA, healthcare professionals can preselect the most relevant treatment options.

Conclusions: Early and iterative involvement of relevant stakeholders in the development process of the PDA helped the alignment of the PDA with the needs and preferences of the diverse end-users. In a future study, we will investigate the effectiveness of the PDA in facilitating SDM in T2DM care.

Trial registration: International Clinical Trials Registry Platform ID: NL8948, date of registration: 05-10-2020.

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2型糖尿病患者决策辅助的发展:以患者为中心的方法。
背景:患者决策辅助(pda)可以有效地促进患者和医疗保健专业人员之间的共享决策(SDM)。国际患者辅助决策标准(IPDAS)合作为系统地开发IPDAS创建了一个模型。然而,缺乏可靠的证据基础限制了对最佳做法的实际建议。例如,确定患者和保健专业人员的需求和偏好的最适当方法存在不确定性。本研究旨在利用IPDAS模型详细介绍2型糖尿病(T2DM) PDA的发展过程。方法:从2020年9月到2023年2月,我们在荷兰系统地开发了T2DM的PDA。我们采用以患者为中心的方法,研究患者的考虑因素,并积极与多学科指导小组合作,包括2型糖尿病患者、患者组织和医疗保健专业人员。PDA的内容和原型开发是通过结合患者的需求和偏好、指导小组的意见以及有关T2DM治疗方案的现有证据来确定的。研究小组和指导小组反复审查了PDA原型。结果:开发了基于网络的PDA,包括五个部分:1)T2DM的信息和可用的治疗方案;2)治疗方案比较;3)评估患者知识的问题;4)价值澄清练习;5)总结患者通过PDA的历程。在患者使用PDA之前,医疗保健专业人员可以预先选择最相关的治疗方案。结论:在PDA的开发过程中,相关利益相关者的早期和反复参与有助于使PDA与不同终端用户的需求和偏好保持一致。在未来的研究中,我们将探讨PDA在T2DM护理中促进SDM的有效性。试验注册:国际临床试验注册平台ID: NL8948,注册日期:05-10-2020。
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