Premium
Decision aids for people with Type 2 diabetes mellitus: an effectiveness rapid review and meta‐analysis
Author(s) -
Karagiannis T.,
Andreadis P.,
Manolopoulos A.,
Malandris K.,
Avgerinos I.,
Karagianni A.,
Tsapas A.
Publication year - 2019
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13939
Subject(s) - medicine , randomized controlled trial , medline , confidence interval , cochrane library , meta analysis , diabetes mellitus , family medicine , intensive care medicine , physical therapy , political science , law , endocrinology
Aims To perform a rapid review and meta‐analysis of randomized controlled trials ( RCT s) evaluating patient decision aids (Pt DA s) for people with Type 2 diabetes mellitus. Methods We searched Medline and the Cochrane Library for RCT s assessing Pt DA s in people with Type 2 diabetes. Pt DA s were defined as tools designed to help people engage in decision‐making about healthcare options, such as making treatment choices or setting therapeutic goals. The study selection process was facilitated by an automated screening tool to identify RCT s. We classified outcomes into seven domains and conducted meta‐analyses using random effects models. Results We included a total of 15 studies, nine of which were cluster RCT s, that evaluated 10 Pt DA s. Thirteen trials compared a Pt DA with usual care or usual care plus educational material, whereas two RCT s compared individually tailored vs. non‐tailored Pt DA s. Meta‐analyses showed a favourable effect of Pt DA s compared with usual care in reducing decisional conflict [weighted mean difference ( WMD ) −4.66, 95% confidence interval ( CI ) −7.93 to −1.39] and in improving knowledge ( WMD 20.46, 95% CI 9.13 to 3.77). Use of Pt DA s resulted in more active involvement in decision‐making during the consultation, although no effect was evident in terms of glycaemic control or self‐reported medication adherence. Conclusions Pt DA s for people with Type 2 diabetes can improve the quality of decision‐making and increase knowledge transfer. Interpretation of our findings is attenuated due to limitations related to the rapid review approach, including searching only two databases and performing data extraction and risk of bias assessment by a single reviewer.