Preferred Conversation Topics with Respect to Treatment Decisions Among Individuals with Type 2 Diabetes

Development of a patient decision aid for type 2 diabetes mellitus: a patient-centered approach

BACKGROUND

Patient decision aids (PDAs) can effectively facilitate shared decision-making (SDM) between patients and healthcare professionals. The International Patient Decision Aid Standards (IPDAS) Collaboration created a model for the systematic development of PDAs. However, the absence of a solid evidence base limits practical recommendations for best practices. For example, uncertainties exist about the most appropriate method for identifying the needs and preferences of patients and healthcare professionals. This study aims to detail the development process for the development of a PDA for type 2 diabetes mellitus (T2DM), using the IPDAS model.

METHODS

From September 2020 to February 2023, we systematically developed the PDA for T2DM in the Netherlands. We adopted a patient-centered approach by researching patient considerations and actively collaborating with a multidisciplinary steering group, including patients with T2DM, patient organizations, and healthcare professionals. The PDA content and prototype development were determined by incorporating patients' needs and preferences, input from the steering group, and available evidence regarding T2DM treatment options. The research team and steering group iteratively reviewed the PDA prototype.

RESULTS

A web-based PDA was developed consisting of five sections: 1) information about T2DM and the available treatment options; 2) comparison of treatment options; 3) questions to assess patients' knowledge; 4) value-clarification exercise; and 5) summary of the patient's journey through the PDA. Before patients use the PDA, healthcare professionals can preselect the most relevant treatment options.

CONCLUSIONS

Early and iterative involvement of relevant stakeholders in the development process of the PDA helped the alignment of the PDA with the needs and preferences of the diverse end-users. In a future study, we will investigate the effectiveness of the PDA in facilitating SDM in T2DM care.

TRIAL REGISTRATION

International Clinical Trials Registry Platform ID: NL8948, date of registration: 05-10-2020.

Customization options in consumer health information materials on type-2 diabetes mellitus-an analysis of modifiable features in different types of media

Introduction

The understanding of health-related information is essential for making informed decisions. However, providing health information in an understandable format for everyone is challenging due to differences in consumers' health status, disease knowledge, skills, and preferences. Tailoring health information to individual needs can improve comprehension and increase health literacy.

Objective

The aim of our research was to analyze the extent to which consumers can customize consumer health information materials (CHIMs) for type-2 diabetes mellitus through various media types.

Methods

We conducted a comprehensive search for various CHIMs across various media types, such as websites, apps, videos, and printed or printable forms. A representative sample of CHIMs was obtained for analysis through blocked randomization across the various media types. We conducted a quantitative content analysis to determine the frequency of user-centered customization options. Cross-comparisons were made to identify trends and variations in modifiable features among the media.

Results

In our representative sample of 114 CHIMs, we identified a total of 24 modifiable features, which we grouped into five main categories: (i) language, (ii) text, (iii) audiovisual, (iv) presentation, and (v) medical content. Videos offered the most customization opportunities (95%), while 47% of websites and 26% of apps did not allow users to tailor health information. None of the printed or printable materials provided the option to customize the information. Overall, 65% of analyzed CHIMs did not allow users to tailor health information according to their needs.

Conclusion

Our results show that CHIMs for type-2 diabetes mellitus could be significantly improved by providing more customization options for users. Further research is needed to investigate the effectiveness and usability of these options to enhance the development and appropriate provision of modifiable features in health information.