Diabetes Decision-Making Tools Improve Patients' Medication Understanding and Follow-Through
A study from the Mayo Clinic has found that using a decision-making tool with patients when discussing medication options makes them more likely to take their prescribed medicine.
Led by Dr. Victor Montori, the Wiser Choice Program is doing research into the use of decision aids in clinical practice, with the aim of making tools that doctors can use to help patients understand the advantages and drawbacks of medications they're considering.
They have developed a set of cards, called Diabetes Medication Choice Decision Aid Cards, that guide a patient through the pros and cons of each possible diabetes medication, answering their questions about differences among the possible choices, so that patients can make an informed decision with their doctor and end up with a strong grasp of why they're on that medicine and what it will do for them. With this understanding, the patient is more likely to take the medication.
Dr. Montori's most recent decision aid is a picture-filled booklet that takes patients through factors impacting the decision to go on a statin. Although current guidelines recommend statins for all people with diabetes, many studies have demonstrated limited adherence to statin regimens, possibly because of low patient involvement in the decision to use the medication.
To address this, Dr. Montori's booklet shows patients their ten-year risk of heart attack based upon an individualized assessment of their risk factors; it then depicts the actual reduction in their risk when taking statins, as well as the disadvantages of using statins. The booklet concludes with a checklist asking patients what action they would like to take, giving them an excellent basis upon which to have an informed conversation with their caregivers.
Dr. Montori recently conducted a trial to assess the efficacy of his Statin Choice decision aid. Among patients who received the decision aid, there was a reduction in conflict about their decision, an improvement in their ability to estimate the risk reduction provided by statins, and a threefold increase in the percentage of those still taking their statin after three months.
Sources: The Mayo Clniic
Archives of Internal Medicine