Diabetes mellitus aid helps decision making

Use of the Diabetes Medication Choice cards can help patients with diabetes mellitus (DM) and their primary care physicians by increasing patients’ involvement in making decisions about DM medications. However, adherence to treatment and outcomes may not be improved.

Mullan and coworkers developed the decision aid, a patient-friendly tool that describes 5 antihyperglycemic medications, their treatment burden, and their effect on hemoglobin A_1c (HbA_1c) levels. The aid was used by 21 randomly selected physicians; the results were compared with those achieved by 19 doctors who administered usual care and distributed an educational pamphlet. Adherence to treatment was monitored via telephone at 1, 3, and 6 months and pharmacy record review at 6 months after the physician visit.

Patients introduced to the decision aid found it helpful. They became more knowledgeable about antihyperglycemic medications than the usual-care patients and more engaged in deciding about their care. Adherence to medications at 6 months was good in both groups but better in the usual-care group. The decision aid also did not affect glycemic control, as assessed by HbA_1c levels, or patient-reported health status.

The authors noted that their findings, although preliminary, may begin to inform policy about patient involvement in health care decisions.