TY - JOUR
T1 - Effect of the statin choice encounter decision aid in Spanish patients with type 2 diabetes
T2 - A randomized trial
AU - Perestelo-Pérez, Lilisbeth
AU - Rivero-Santana, Amado
AU - Boronat, Mauro
AU - Sánchez-Afonso, Juan A.
AU - Pérez-Ramos, Jeanette
AU - Montori, Victor M.
AU - Serrano-Aguilar, Pedro
N1 - Publisher Copyright:
© 2015 Elsevier Ireland Ltd.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objective: Statin choice, an encounter decision aid (DA), was developed in the USA to facilitate shared decision making between patients and clinicians about the use of statins to reduce cardiovascular risk. We aimed to assess the efficacy of this DA, compared to usual primary care, in Spanish patients with type 2 diabetes. Methods: Cluster randomized trial with 29 clinicians and 168 patients. Knowledge of statins, cardiovascular risk perception, decisional conflict, anxiety and satisfaction with the decision making process were assessed immediately after intervention, and self-reported adherence at three months. Results: Intervention significantly improved knowledge (p = 0.01), perception of the 10-year risk of myocardial infarction without (p = 0.01) and with statins (p = 0.08), and satisfaction (p = 0.01). There were no significant differences in decisional conflict, anxiety, consultation time or adherence, although more intervention patients reported taking all pills during the last week (92.7% vs. 81%; p = 0.19). Conclusion: The statin choice DA improved the quality of decision making about statins. Practice implications: This trial contributes to the body of evidence substantiating the efficacy of statin choice and extending it to Spanish clinicians and their patients with type 2 diabetes. Trial registration: This trial is registered with the European Union Clinical Trials Register (EudraCT: 2010-023912-14).
AB - Objective: Statin choice, an encounter decision aid (DA), was developed in the USA to facilitate shared decision making between patients and clinicians about the use of statins to reduce cardiovascular risk. We aimed to assess the efficacy of this DA, compared to usual primary care, in Spanish patients with type 2 diabetes. Methods: Cluster randomized trial with 29 clinicians and 168 patients. Knowledge of statins, cardiovascular risk perception, decisional conflict, anxiety and satisfaction with the decision making process were assessed immediately after intervention, and self-reported adherence at three months. Results: Intervention significantly improved knowledge (p = 0.01), perception of the 10-year risk of myocardial infarction without (p = 0.01) and with statins (p = 0.08), and satisfaction (p = 0.01). There were no significant differences in decisional conflict, anxiety, consultation time or adherence, although more intervention patients reported taking all pills during the last week (92.7% vs. 81%; p = 0.19). Conclusion: The statin choice DA improved the quality of decision making about statins. Practice implications: This trial contributes to the body of evidence substantiating the efficacy of statin choice and extending it to Spanish clinicians and their patients with type 2 diabetes. Trial registration: This trial is registered with the European Union Clinical Trials Register (EudraCT: 2010-023912-14).
KW - Cardiovascular risk
KW - Communication
KW - Decision aid
KW - Patient involvement (empowerment
KW - Randomized controlled trial
KW - Self-management)
KW - Shared decision making
KW - Spain
KW - Statin choice
KW - Type 2 diabetes
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U2 - 10.1016/j.pec.2015.08.032
DO - 10.1016/j.pec.2015.08.032
M3 - Article
C2 - 26343571
AN - SCOPUS:84959570940
SN - 0738-3991
VL - 99
SP - 295
EP - 299
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 2
ER -