Decision aids for people with Type 2 diabetes mellitus: an effectiveness rapid review and meta‐analysis. Issue 5 (12th March 2019)

• Record Type: Journal Article
• Authors: Karagiannis, T.; Andreadis, P.; Manolopoulos, A.; Malandris, K.; Avgerinos, I.; Karagianni, A.; Tsapas, A.
• Is Part Of: Diabetic medicine. Volume 36:Issue 5(2019)
• Page Start: 557
• Page End: 568
• Publication Date: 2019-03-12
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.13939
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aims: To perform a rapid review and meta‐analysis of randomized controlled trials (RCTs) evaluating patient decision aids (PtDAs) for people with Type 2 diabetes mellitus. Methods: We searched Medline and the Cochrane Library for RCTs assessing PtDAs in people with Type 2 diabetes. PtDAs 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 RCTs. 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 RCTs, that evaluated 10 PtDAs. Thirteen trials compared a PtDA with usual care or usual care plus educational material, whereas two RCTs compared individually tailored vs. non‐tailored PtDAs. Meta‐analyses showed a favourable effect of PtDAs 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 PtDAs 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: PtDAs 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. What's new?: This is the first synthesis focusing on randomized controlled trials (RCTs) assessing the effect of decision aids on a variety of outcomes for people with Type 2 diabetes mellitus. Data from RCTs evaluating decision aids for people with Type 2 diabetes used before and/or during the clinical consultation can improve quality of decision‐making, knowledge transfer and active participation in decision‐making. Use of decision aids did not affect glycaemic control or medication adherence. Our study supports the utility of automated screening software to expedite the study selection process of a systematic review.