Details

Autor(en) / Beteiligte

• Moin, Tannaz
• Duru, O. Kenrik
• Turk, Norman
• Chon, Janet S.
• Frosch, Dominick L.
• Martin, Jacqueline M.
• Jeffers, Kia Skrine
• Castellon-Lopez, Yelba
• Tseng, Chi-Hong
• Norris, Keith
• Mangione, Carol M.

Titel

Effectiveness of Shared Decision-making for Diabetes Prevention: 12-Month Results from the Prediabetes Informed Decision and Education (PRIDE) Trial

Ist Teil von

• Journal of general internal medicine : JGIM, 2019-11, Vol.34 (11), p.2652-2659

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Importance Intensive lifestyle change (e.g., the Diabetes Prevention Program) and metformin reduce type 2 diabetes risk among patients with prediabetes. However, real-world uptake remains low. Shared decision-making (SDM) may increase awareness and help patients select and follow through with informed options for diabetes prevention that are aligned with their preferences. Objective To test the effectiveness of a prediabetes SDM intervention. Design Cluster randomized controlled trial. Setting Twenty primary care clinics within a large regional health system. Participants Overweight/obese adults with prediabetes (BMI ≥ 24 kg/m 2 and HbA1c 5.7–6.4%) were enrolled from 10 SDM intervention clinics. Propensity score matching was used to identify control patients from 10 usual care clinics. Intervention Intervention clinic patients were invited to participate in a face-to-face SDM visit with a pharmacist who used a decision aid (DA) to describe prediabetes and four possible options for diabetes prevention: DPP, DPP ± metformin, metformin only, or usual care. Main Outcomes and Measures Primary endpoint was uptake of DPP (≥ 9 sessions), metformin, or both strategies at 4 months. Secondary endpoint was weight change (lbs.) at 12 months. Results Uptake of DPP and/or metformin was higher among SDM participants ( n  = 351) than controls receiving usual care ( n  = 1028; 38% vs. 2%, p  < .001). At 12-month follow-up, adjusted weight loss (lbs.) was greater among SDM participants than controls (− 5.3 vs. − 0.2, p  < .001). Limitations Absence of DPP supplier participation data for matched patients in usual care clinics. Conclusions and Relevance A prediabetes SDM intervention led by pharmacists increased patient engagement in evidence-based options for diabetes prevention and was associated with significantly greater uptake of DPP and/or metformin at 4 months and weight loss at 12 months. Prediabetes SDM may be a promising approach to enhance prevention efforts among patients at increased risk. Trial Registration This study was registered at clinicaltrails.gov ( NCT02384109) ).