Division of General Internal Medicine, Mount Sinai School of Medicine, New York, NY, USA.
Patient Educ Couns. 2010 Jul;80(1):138-40. doi: 10.1016/j.pec.2009.10.008. Epub 2009 Dec 2.
To assess the impact of a decision aid on perceived risk of heart attacks and medication adherence among urban primary care patients with diabetes.
We randomly allocated 150 patients with diabetes to participate in a usual primary care visit either with or without the Statin Choice tool. Participants completed a questionnaire at baseline and telephone follow-up at 3 and 6 months.
Intervention patients were more likely to accurately perceive their underlying risk for a heart attack without taking a statin (OR: 1.9, CI: 1.0-3.8) and with taking a statin (OR: 1.4, CI: 0.7-2.8); a decline in risk overestimation among patients receiving the decision aid accounts for this finding. There was no difference in statin adherence at 3 or 6 months.
A decision aid about using statins to reduce coronary risk among patients with diabetes improved risk communication, beliefs, and decisional conflict, but did not improve adherence to statins.
Decision aid enhanced communication about the risks and benefits of statins improved patient risk perceptions but did not alter adherence among patients with diabetes.
评估决策辅助工具对城市初级保健糖尿病患者心脏病发作风险感知和药物依从性的影响。
我们随机分配了 150 名糖尿病患者，在常规初级保健就诊中接受他汀类药物选择工具（StatinChoice tool）或不接受该工具。参与者在基线时完成了一份问卷，并在 3 个月和 6 个月时进行了电话随访。
干预组更有可能准确地感知到他们在不服用他汀类药物（OR：1.9，CI：1.0-3.8）和服用他汀类药物（OR：1.4，CI：0.7-2.8）时患心脏病的潜在风险；接受决策辅助工具的患者的风险高估有所下降，这导致了这一发现。在 3 个月或 6 个月时，他汀类药物的依从性没有差异。
一种关于使用他汀类药物降低糖尿病患者冠心病风险的决策辅助工具改善了风险沟通、信念和决策冲突，但并没有改善他汀类药物的依从性。
决策辅助工具增强了关于他汀类药物风险和益处的沟通，改善了患者的风险感知，但没有改变糖尿病患者的依从性。
