Macalalad-Josue Anna Angelica, Palileo-Villanueva Lia Aileen, Sandoval Mark Anthony, Panuda Jose Paolo
Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of the Philippines-Philippine General Hospital.
Section of Adult Medicine, Department of Medicine, University of the Philippines-Philippine General Hospital.
J ASEAN Fed Endocr Soc. 2019;34(1):44-55. doi: 10.15605/jafes.034.01.08. Epub 2019 Apr 4.
To develop a locally adapted patient decision aid (PtDA) on treatment intensification among Filipino patients with Type 2 Diabetes Mellitus and to test the feasibility of using PtDAs in a low middle-income country.
A qualitative approach and an iterative process of development of a PtDA were employed for this study. We describe the process of developing a Filipino version of the Diabetes Medication Decision Aid. This PtDA was designed to help the patient choose the appropriate treatment intensification based on his own values and preferences, in consultation with his physician. The process involved decisional needs assessment through focus group discussions and key informant interviews, systematic literature review, iterative process of the development of a PtDA with clinical encounters (pilot testing), and preliminary field testing.
Decisional needs assessment revealed that Filipino patients are open to participate in shared decision-making if given the opportunity, including those with low socioeconomic status who likely have low health literacy. Physicians prefer to have visual aid tools to help them support their patient's decision-making. A PtDA prototype of a set of flash cards in Filipino was created and revised in an iterative method. We developed a more visually appealing tool after inputs from the expert panel and patient advisory group. Its use during clinical encounters provided additional insights from patients and clinicians on how to improve the PtDA. Preliminary field testing showed that its use is feasible in the target patient population.
Filipino patients, clinicians, and diabetes nurse educators have contributed to the creation of the first Filipino PtDA for diabetes treatment intensification.
开发一种适合当地情况的患者决策辅助工具（PtDA），用于菲律宾2型糖尿病患者的强化治疗，并测试在中低收入国家使用PtDA的可行性。
本研究采用定性方法和PtDA的迭代开发过程。我们描述了开发菲律宾语版糖尿病药物治疗决策辅助工具的过程。该PtDA旨在帮助患者根据自身价值观和偏好，在与医生协商后选择合适的强化治疗方案。该过程包括通过焦点小组讨论和关键信息提供者访谈进行决策需求评估、系统的文献综述、通过临床会诊（试点测试）对PtDA进行迭代开发过程以及初步现场测试。
决策需求评估显示，如果有机会，菲律宾患者愿意参与共同决策，包括那些社会经济地位较低、健康素养可能也较低的患者。医生更喜欢有视觉辅助工具来帮助他们支持患者的决策。创建了一套菲律宾语抽认卡形式的PtDA原型，并以迭代方式进行了修订。在专家小组和患者咨询小组提供意见后，我们开发了一种更具视觉吸引力的工具。在临床会诊中使用该工具为患者和临床医生提供了关于如何改进PtDA的更多见解。初步现场测试表明，在目标患者群体中使用该工具是可行的。
菲律宾患者、临床医生和糖尿病护士教育工作者为创建首个用于糖尿病强化治疗的菲律宾语PtDA做出了贡献。
