Abstract
BACKGROUND: Our study utilized patient decision aids (PDA) to explore the influence of shared decision making (SDM) on type 2 diabetes patients' intention to use subcutaneous antidiabetic agents. METHODS: A prospective observational comparative study was conducted involving 249 patients with type 2 diabetes who were referred by physicians and subsequently interviewed by pharmacists across different clinics. Patients were classified into two parallel groups based on routine clinical practice. A patient decision aid (PDA) entitled "Type 2 Diabetes: Oral or Subcutaneous Antidiabetic Agents for My Diabetes Control" was developed for this study. Data collection focused on patients' intention to initiate subcutaneous antidiabetic agents, post-test knowledge scores, and satisfaction with clinical visits. These outcomes were compared between the SDM group, which received pharmacist-facilitated shared decision making using a PDA, and the PDA self-completion (control) group, which received usual care and completed the PDA by self-review. RESULTS: A total of 249 patients were included (SDM group n = 123; control group n = 126). The SDM group had higher baseline disease severity indicators. After adjustment, the SDM group demonstrated higher decision-making (adjusted mean difference 0.59, 95% CI 0.17-1.00), knowledge (0.84, 95% CI 0.59-1.09), and satisfaction (1.86, 95% CI 0.98-2.73) scores compared with controls. CONCLUSIONS: PDA-supported shared decision making was associated with higher short-term decision-making intentions, knowledge, and satisfaction among patients with type 2 diabetes. These findings suggest that PDAs may support patients in considering injectable treatment options, although conclusions regarding treatment initiation or clinical outcomes require further longitudinal evaluation.