Diabetes Decision-Making Tools Improve Patients’ Medication Understanding and Follow-Through

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By: Linda von Wartburg

A study from the Mayo Clinic has found that using a decision-makingtool with patients when discussing medication options makes themmore likely to take their prescribed medicine.

Led by Dr. Victor Montori, the Wiser Choice Program is doingresearch into the use of decision aids in clinical practice, withthe aim of making tools that doctors can use to help patientsunderstand the advantages and drawbacks of medications they'reconsidering.

They have developed a set of cards, called Diabetes MedicationChoice Decision Aid Cards, that guide a patient through the pros andcons of each possible diabetes medication, answering their questionsabout differences among the possible choices, so that patients canmake an informed decision with their doctor and end up with a stronggrasp of why they're on that medicine and what it will do for them.With this understanding, the patient is more likely to take themedication.

Dr. Montori's most recent decision aid is a picture-filled bookletthat takes patients through factors impacting the decision to go ona statin. Although current guidelines recommend statins for allpeople with diabetes, many studies have demonstrated limitedadherence to statin regimens, possibly because of low patientinvolvement in the decision to use the medication.

To address this, Dr. Montori's booklet shows patients theirten-year risk of heart attack based upon an individualizedassessment of their risk factors; it then depicts the actualreduction in their risk when taking statins, as well as thedisadvantages of using statins. The booklet concludes with achecklist asking patients what action they would like to take,giving them an excellent basis upon which to have an informedconversation with their caregivers.

Dr. Montori recently conducted a trial to assess the efficacy of hisStatin Choice decision aid. Among patients who received the decisionaid, there was a reduction in conflict about their decision, animprovement in their ability to estimate the risk reduction providedby statins, and a threefold increase in the percentage of thosestill taking their statin after three months.

Sources: The Mayo Clniic
Archives of Internal Medicine

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