The design of a decision aid about diabetes medications for use during the consultation with patients with type 2 diabetes.
OBJECTIVE
To describe the process used to develop a medication choice decision aid (DA) for patients with type 2 diabetes.


METHODS
We developed the DA through active collaboration with patients, clinicians, and designers, direct observations of clinical encounters, literature review, and collaborative development of design criteria. Insights from these processes informed the iterative creation of prototypes that were reviewed and field tested in actual consultations.


RESULTS
The goal of the DA was to facilitate a conversation between the clinician and the patient about diabetes medication options. Four iterations of the DA were developed and field-tested before arriving at issue cards that organized the data for five medications around glucose control, hypoglycemia, weight changes, daily routine, self-monitoring and side effects. These cards successfully generated conversations during consultations. An ongoing clinical trial will determine if this DA affects patient adherence and outcomes.


CONCLUSIONS
A collaboratively developed DA designed to create a conversation about diabetes medications may lead to more patient-centered treatment choices.


CONCLUSIONS
If effective, this DA could replace disease-centered treatment algorithms for patient-centered conversations that enhance the management of patients with type 2 diabetes.
Breslin
Maggie
M
Department of Medicine, Knowledge and Encounter Research Unit and the SPARC Innovation Program, Mayo Clinic College of Medicine, Rochester 55905, MN, USA.
Mullan
Rebecca J
RJ
Montori
Victor M
VM
D001291:Attitude of Health Personnel; D001296:Audiovisual Aids / Q000592:standards*; D002755:Choice Behavior; D003142:Communication; D003299:Cooperative Behavior; D003661:Decision Support Techniques; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008910:Minnesota; D020380:Needs Assessment; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D018579:Patient Selection; D018802:Patient-Centered Care; D011369:Professional-Patient Relations; D012017:Referral and Consultation; D018570:Risk Assessment; D012380:Role
D007004:Hypoglycemic Agents