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dc.contributor.authorBuhse, Susanne
dc.contributor.authorMuhlhauser, Ingrid
dc.contributor.authorHeller, Tabitha
dc.contributor.authorKuniss, Nadine
dc.contributor.authorMuller, Ulrich
dc.contributor.authorKasper, Jürgen
dc.contributor.authorLehmann, Thomas
dc.contributor.authorLenz, Matthias
dc.date.accessioned2016-03-14T07:37:44Z
dc.date.available2016-03-14T07:37:44Z
dc.date.issued2015-11-13
dc.description.abstractObjective: To evaluate an informed shared decisionmaking programme (ISDM-P) for people with type 2 diabetes under high fidelity conditions. <p>Design: Randomised, single-blinded trial with sham control intervention and follow-up of 6 months. <p>Setting: Single-centre diabetes clinic providing care according to the national disease management programme in Germany. <p>Participants: 154 people with type 2 diabetes without diagnosis of ischaemic heart disease or stroke. Interventions: The ISDM-P is executed by diabetes educators. Core component is a patient decision aid on the prevention of myocardial infarction supplemented by a 90 min group teaching session. The structurally equivalent control intervention addresses stress issues. <p>Main outcome measures: Primary outcome was risk comprehension, including realistic expectations about benefits and harms of interventions. It was assessed by a 12-item questionnaire after the teaching session when patients set and prioritise their treatment goals. Key secondary outcome was adherence to treatment goals, operationalised as achievement of individual goals and medication uptake. ISDM-P teaching sessions were video-taped to monitor intervention fidelity. <p>Results: 72 of 77 ISDM-P and 71 of 77 control patients completed the questionnaire (score 0–12). ISDM-P patients achieved higher levels of risk comprehension, mean score 8.25 vs 2.62, difference 5.63 (95% CI 4.82 to 6.44), and realistic expectations (score 0–6), 4.51 vs 0.85, 3.67 (3.23 to 4.11). More ISDM-P patients wished to take statins, 59.2% vs 30.4%, 28.7% (12.9% to 44.5%); more prioritised blood pressure control, 51.4% vs 25.7%, and fewer intensive glucose control, 33.3% vs 60%, p=0.002. More ISDM-P patients achieved their glycated haemoglobin goals, 95.8% vs 85.7%, 10.1% (0.6% to 19.5%). Achievement of prioritised goals and medication uptake were comparable between groups. <p>Conclusions: The ISDM-P on preventive measures in type 2 diabetes was effective under high fidelity conditions. Involvement of diabetes educators may facilitate implementation of the informed shared decision-making. <p>Trial registration number: ISRCTN84636255.en_US
dc.descriptionPublished version, also available at <a href=http://dx.doi.org/10.1136/bmjopen-2015-009116>http://dx.doi.org/10.1136/bmjopen-2015-009116</a>en_US
dc.identifier.citationBMJ Open 2015, 5(11)en_US
dc.identifier.cristinIDFRIDAID 1319801
dc.identifier.doi10.1136/bmjopen-2015-009116
dc.identifier.issn2044-6055
dc.identifier.urihttps://hdl.handle.net/10037/8904
dc.identifier.urnURN:NBN:no-uit_munin_8497
dc.language.isoengen_US
dc.publisherBMJ Publishing Groupen_US
dc.rights.accessRightsopenAccess
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771en_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771en_US
dc.titleInformed shared decision-making programme on the prevention of myocardial infarction in type 2 diabetes: A randomised controlled trialen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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