title: Information and decision support needs in patients with type 2 diabetes.
abstract: Diabetes and its sequelae cause a growing burden of morbidity and mortality. For many patients living with diabetes, the Internet is an important source of health information and support. In the course of the development of an Interactive Health Communication Application, combining evidence-based information with behavior change and decision support, we assessed the characteristics, information, and decision support needs of patients with type 2 diabetes.The needs assessment was performed in two steps. First, we conducted semi-structured interviews with 10 patients and seven physicians. In the second step, we developed a self-assessment questionnaire based on the results of the interviews and administered it to a new and larger sample of diabetes patients (N = 178). The questionnaire comprised four main sections: (1) Internet use and Internet experience, (2) diabetes knowledge, (3) relevant decisions and decision preferences, and (4) online health information needs. Descriptive data analyses were performed.In the questionnaire study, the patient sample was heterogeneous in terms of age, time since diagnosis, and glycemic control. (1) Most participants (61.7%) have searched the web for health information at least once. The majority (62%) of those who have used the web use it at least once per month. (2) Diabetes knowledge was scarce: Only a small percentage (1.9%) of the respondents answered all items of the knowledge questionnaire correctly. (3) The most relevant treatment decisions concerned glycemic control, oral medication, and acute complications. The most difficult treatment decision was whether to start insulin treatment. Of the respondents, 69.4 percent thought that medical decisions should be made by them and their doctor together. (4) The most important information needs concerned sequelae of diabetes, blood glucose control, and basic diabetes information.The Internet seems to be a feasible way to reach people with type 2 diabetes. The heterogeneity of the sample, especially with respect to diabetes knowledge, makes it clear that the projected Interactive Health Communication Application should tailor the content to the individual user, taking account of individual characteristics and preferences. A wide range of topics should be covered. Special attention should be paid to the advantages and disadvantages of insulin treatment and the fears and hopes associated with it. These results were taken into account when developing the Interactive Health Communication Application that is currently being evaluated in a randomized controlled trial (International Clinical Trials Registry DRKS00003322).
authors.affiliation: University Medical Center Hamburg-Eppendorf, Germany n.weymann@uke.de.
authors.forename: Nina
authors.initials: N
authors.lastname: Weymann
authors.affiliation: University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Härter
authors.affiliation: University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Dirmaier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy*; D005260:Female; D066275:Health Information Exchange / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care; D011795:Surveys and Questionnaires
keywords: Internet; decision support; diabetes mellitus; needs assessment; patient information