DC2439 - Effectiveness of Patient Decision Aids for Diabetes Related Decisions: Sub-analysis of a Systematic Review

Blinded Abstract:

Background: Patient decision aids (PtDAs) are evidence-based interventions designed to help patients make informed health decisions aligned with their values and preferences. The aim of this sub-analysis was to evaluate the effectiveness of PtDAs for adults facing diabetes related screening, prevention and treatment decisions.

Methods: We conducted a sub-analysis of RCTs included in the 2024 update of the Cochrane systematic review of PtDAs compared to usual care. Two reviewers independently screened 209 included trials to identify studies addressing diabetes related screening, prevention and treatment decisions. Primary outcomes were attributes of the choice made (e.g., informed values-choice congruence) and attributes of decision-making process (e.g., knowledge, accurate risk perceptions, decisional conflict related to feeling informed and feeling clear about values, participation in decision making). We conducted meta-analysis for similar outcome measures.

Results: Of 209 RCTs, 11 studies evaluated diabetes related decisions including 7 about treatments, 3 screening and 1 prevention. Treatment decisions were about diabetes medication intensification (n = 4) and statin initiation (n = 3). Compared with usual care, adults exposed to PDAs made better quality decisions as evidenced by increased patient knowledge (MD 16.06, 95% CI 8.38 to 23.75) and fewer with unclear values (MD -7.43, 95% CI -13.23, -1.63). There was no difference for accurate risk perception, feeling uninformed and choice for starting new medications for diabetes related prevention and treatment decisions.

Conclusion: PtDA improved participants’ knowledge and helped them feel clearer about their values for features and outcomes of options for diabetes related screening, prevention and treatment decisions.