title: Mismatch between health-care professionals' and patients' views on a diabetes patient decision aid: a qualitative study.
abstract: BACKGROUND
  Malaysia is an Asian country with population of diverse culture and health perceptions. Patient decision aid (PDA) is a new tool in Malaysia. Patients' and health-care professionals' (HCPs) expectation of a PDA is unknown.
  
  
  OBJECTIVE
  We aimed to explore patients' and health-care professionals'(HCPs) views on the information needed in a patient decision aid (PDA) on insulin initiation developed for patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  We used a qualitative design and thematic approach.
  
  
  METHODS
  Three main primary health-care settings in Malaysia: public university-based primary care clinics, public health-care clinics and private general practices.
  
  
  METHODS
  We conducted focus groups and one-to-one interviews with a purposive sample of health professionals and patients with type 2 diabetes.
  
  
  RESULTS
  We interviewed 18 patients and 13 HCPs. Patients viewed the content of the PDA as simple and clear. However, HCPs felt the PDA might be difficult for patients with low literacy to understand. HCPs thought the PDA was too lengthy. Nevertheless, patients would prefer more information. HCPs tended to focus on benefits of insulin, while patients wanted to know the impact of insulin on their quality of life and practical issues regarding insulin and its side-effects. Patients preferred numbers to weigh the risks and benefits of treatment options. HCPs' views that presenting numbers in a PDA would be too complex for patients to understand.
  
  
  CONCLUSIONS
  It is important to consider including issues related to psycho-social impact of treatment to patients when developing a patient decision aid.
authors: Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia.
authors: Ping Yein
authors: PY
authors: Lee
authors: Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: Ee Ming
authors: EM
authors: Khoo
authors: Dean's Office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: Wah Yun
authors: WY
authors: Low
authors: Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: Yew Kong
authors: YK
authors: Lee
authors: Department of Nursing Sciences, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: Khatijah Lim
authors: KL
authors: Abdullah
authors: Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: Syahidatul Akmal
authors: SA
authors: Azmi
authors: Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: Chirk Jenn
authors: CJ
authors: Ng
mesh_terms: D000328:Adult; D000368:Aged; D003661:Decision Support Techniques; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007407:Interviews as Topic; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D011320:Primary Health Care; D036301:Qualitative Research; D011788:Quality of Life
chemical_list: D007328:Insulin
keywords: patient decision aid; patients' and doctors' view