Breslin Maggie, Mullan Rebecca J, Montori Victor M
Department of Medicine, Knowledge and Encounter Research Unit and the SPARC Innovation Program, Mayo Clinic College of Medicine, Rochester 55905, MN, USA.
Patient Educ Couns. 2008 Dec;73(3):465-72. doi: 10.1016/j.pec.2008.07.024. Epub 2008 Sep 3.
To describe the process used to develop a medication choice decision aid (DA) for patients with type 2 diabetes.
We developed the DA through active collaboration with patients, clinicians, and designers, direct observations of clinical encounters, literature review, and collaborative development of design criteria. Insights from these processes informed the iterative creation of prototypes that were reviewed and field tested in actual consultations.
The goal of the DA was to facilitate a conversation between the clinician and the patient about diabetes medication options. Four iterations of the DA were developed and field-tested before arriving at issue cards that organized the data for five medications around glucose control, hypoglycemia, weight changes, daily routine, self-monitoring and side effects. These cards successfully generated conversations during consultations. An ongoing clinical trial will determine if this DA affects patient adherence and outcomes.
A collaboratively developed DA designed to create a conversation about diabetes medications may lead to more patient-centered treatment choices.
If effective, this DA could replace disease-centered treatment algorithms for patient-centered conversations that enhance the management of patients with type 2 diabetes.
描述为2型糖尿病患者开发药物选择决策辅助工具（DA）的过程。
我们通过与患者、临床医生和设计师积极合作，直接观察临床诊疗过程，进行文献综述以及共同制定设计标准来开发该决策辅助工具。这些过程中获得的见解为迭代创建原型提供了依据，这些原型在实际咨询中得到了审查和实地测试。
该决策辅助工具的目标是促进临床医生与患者之间关于糖尿病药物选择的对话。在得出问题卡片之前，对决策辅助工具进行了四轮开发和实地测试，这些问题卡片围绕血糖控制、低血糖、体重变化、日常安排、自我监测和副作用等方面整理了五种药物的数据。这些卡片在咨询过程中成功引发了对话。一项正在进行的临床试验将确定该决策辅助工具是否会影响患者的依从性和治疗效果。
通过合作开发的旨在引发关于糖尿病药物对话的决策辅助工具，可能会带来更多以患者为中心的治疗选择。
如果有效，该决策辅助工具可以取代以疾病为中心的治疗算法，进行以患者为中心的对话，从而加强对2型糖尿病患者的管理。
