Ong Ruiheng, Ng Chirk Jenn, Gunasekaran Kalaipriya, Liu Hang, Hsu Wynne, Lee Mong Li, Tan Ngiap Chuan
SingHealth Polyclinics, SingHealth, Singapore, Singapore.
Family Medicine Academic Clinical Programme, SingHealth-Duke NUS Academic Medical Centre, SingaporeSingapore.
PLoS One. 2025 Jul 2;20(7):e0327623. doi: 10.1371/journal.pone.0327623. eCollection 2025.
The inertia to adopt protective health behaviours by patients with diabetes is contributed by underestimation of their risks of diabetes complications. Risk communication, using social comparison of glycaemic control and disease trajectory to other patients of similar clinicodemographic profiles, has potential to increase patients' risk perceptions and motivate protective health behaviours. A digital tool named PERDICT.AI was designed to support primary care physicians (PCPs) in patient similarity-based risk communication to patients with type 2 diabetes mellitus (T2DM).
This study explored the perspectives of patients with uncontrolled T2DM on how their diabetes-related risks were communicated to them by a PCP using PERDICT.AI.
A qualitative design was used. Eighteen participants aged 40-79 with T2DM with ≥1 HBA1c reading ≥8.0% within the last 6 months were recruited from a primary care clinic in Singapore. Each participant went through the risk communication session followed by an in-depth interview. The transcripts were coded and analysed to identify emerging themes.
Five themes emerged representing participants' risk perceptions post-session and social comparison tendencies. These are: 1) 'I am myself', 2) motivation to be like the majority, 3) avoiding similar negative outcomes, 4) low risk does not equate to zero risk, and 5) motivation to replicate how others achieve positive outcomes. Themes 1 and 4 were concurrently represented among some participants; zero risk tolerance for diabetes complications was expressed despite not being motivated by their HBA1c cohort ranking.
This study provided insights into the acceptability of using a social comparison approach in communicating risk to patients with uncontrolled T2DM. It highlights the importance of identifying and selecting patients who are receptive to social comparison, clarifying patients' perceptions of risks, including zero risk, and providing tailored and socially comparable strategies to mitigate these risks.
糖尿病患者采取保护性健康行为的惰性源于对糖尿病并发症风险的低估。通过将血糖控制和疾病轨迹与具有相似临床人口统计学特征的其他患者进行社会比较来进行风险沟通，有可能提高患者的风险认知并激发保护性健康行为。一种名为PERDICT.AI的数字工具旨在支持初级保健医生（PCP）与2型糖尿病（T2DM）患者进行基于患者相似性的风险沟通。
本研究探讨了T2DM控制不佳患者对于初级保健医生使用PERDICT.AI向他们传达糖尿病相关风险的看法。
采用定性设计。从新加坡的一家初级保健诊所招募了18名年龄在40 - 79岁之间、T2DM患者，在过去6个月内糖化血红蛋白（HBA1c）读数≥8.0%。每位参与者参加风险沟通会议，随后进行深入访谈。对访谈记录进行编码和分析，以确定新出现的主题。
出现了五个主题，代表了参与者会后的风险认知和社会比较倾向。这些主题是：1）“我就是我自己”，2）向大多数人看齐的动机，3）避免类似的负面结果，4）低风险并不等同于零风险，5）复制他人实现积极结果方式的动机。一些参与者同时体现了主题1和4；尽管未受其HBA1c队列排名的激励，但对糖尿病并发症表达了零风险容忍度。
本研究深入了解了在向T2DM控制不佳的患者传达风险时使用社会比较方法的可接受性。它强调了识别和选择接受社会比较的患者、明确患者对风险（包括零风险）的认知以及提供量身定制且具有社会可比性的策略以降低这些风险的重要性。
