Roldan Munoz Sonia, Mol Peter G M, de Vries Femke, van Dijk Peter R, Hillege Hans, Postmus Douwe, de Vries Sieta T
Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Faculty of Beta Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Patient Prefer Adherence. 2025 Jan 25;19:215-234. doi: 10.2147/PPA.S486553. eCollection 2025.
Treatment guidelines recommend metformin as initial drug in many people with type 2 diabetes (T2D) and low risk of cardiovascular disease, with the possibility to switch to or add other drug classes. A decision aid (DA) could be useful to incorporate a patient's preferences in the decision of which drug class to choose. We developed such a DA and assessed the perspectives of people with T2D towards its comprehensibility and usability.
The DA consists of a paper-based leaflet followed by a web-based preference elicitation exercise. The leaflet aims at informing patients about drug characteristics (eg, efficacy, safety). The relative importance of these drug characteristics for each participant are then assessed in a web-based exercise, which results in a ranking of the preferred drug classes. A qualitative study using semi-structured interviews was conducted among Dutch patients with T2D who were or had ever been under pharmacological treatment for T2D. The audio-recorded interviews were transcribed verbatim. Thematic analysis was conducted.
Fifteen patients participated (median age 64 years, nine women, and most had T2D >10 years). Risk of hypoglycaemia was most often the characteristic to which patients attached the highest importance (n=5). A glucagon-like peptide-1-antagonist weekly injection fitted best the preferences of most patients (n=8). The interviews revealed improvements for text, pictograms and figures, and formatting, and increased comprehension of how patients completed the DA. Regarding usability, missing information was identified, as well as patients' perspectives about the usefulness of the DA and its role in shared-decision making.
The DA was considered promising for shared-decision making but further improvements regarding its comprehensibility and usability are needed, for which this study provides clear guidance.
治疗指南推荐二甲双胍作为许多2型糖尿病（T2D）且心血管疾病风险较低患者的初始用药，并有可能换用或加用其他药物类别。决策辅助工具（DA）可能有助于在选择药物类别时纳入患者的偏好。我们开发了这样一种DA，并评估了T2D患者对其可理解性和可用性的看法。
该DA包括一份纸质传单，随后是基于网络的偏好诱导练习。传单旨在向患者介绍药物特性（如疗效、安全性）。然后在基于网络练习中评估这些药物特性对每位参与者的相对重要性，从而得出首选药物类别的排名。对接受过或曾经接受过T2D药物治疗的荷兰T2D患者进行了一项使用半结构化访谈的定性研究。对录音访谈进行逐字转录，并进行主题分析。
15名患者参与（中位年龄64岁，9名女性，大多数患有T2D超过10年）。低血糖风险通常是患者认为最重要的特征（n = 5）。胰高血糖素样肽-1拮抗剂每周注射最符合大多数患者的偏好（n = 8）。访谈揭示了文本、象形图和图表以及格式方面的改进，以及患者对如何完成DA的理解有所提高。关于可用性，发现了信息缺失，以及患者对DA的有用性及其在共同决策中的作用的看法。
该DA被认为在共同决策方面有前景，但在可理解性和可用性方面需要进一步改进，本研究为此提供了明确指导。
