Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-14T05:17:41.528Z Has data issue: false hasContentIssue false

3256 Effectiveness of Shared Decision-Making for Diabetes Prevention: 12-month Results from the Prediabetes Informed Decision and Education (PRIDE) Randomized Trial

Published online by Cambridge University Press:  26 March 2019

Tannaz Moin
Affiliation:
University of California, Los Angeles
O. Kenrik Duru
Affiliation:
University of California, Los Angeles
Norman Turk
Affiliation:
University of California, Los Angeles
Janet S. Chon
Affiliation:
University of California, Los Angeles
Dominick L. Frosch
Affiliation:
University of California, Los Angeles
Jacqueline Martin
Affiliation:
University of California, Los Angeles
Kia Skrine Jeffers
Affiliation:
University of California, Los Angeles
Yelba Castellon-Lopez
Affiliation:
University of California, Los Angeles
Chi-Hong Tseng
Affiliation:
University of California, Los Angeles
Keith Norris
Affiliation:
University of California, Los Angeles
Carol M. Mangione
Affiliation:
University of California, Los Angeles
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

OBJECTIVES/SPECIFIC AIMS: Intensive lifestyle change (e.g., the Diabetes Prevention Program) and metformin reduce type 2 diabetes risk among patients with prediabetes. However, real-world uptake remains low. Shared decision-making (SDM) may increase awareness and help patients select and follow through with informed options for diabetes prevention that are aligned with their preferences.The objective was to test the effectiveness of a prediabetes SDM intervention. METHODS/STUDY POPULATION: This was a cluster-randomized controlled trial in 20 primary care clinics within a large regional health system. Participants were overweight/obese adults with prediabetes (BMI>24 kg/m2 and HbA1c 5.7-6.4%) were enrolled from 10 SDM intervention clinics. Propensity score matching was used to identify control patients from 10 usual care clinics.Intervention clinic patients were invited to participate in a face-to-face SDM visit with a pharmacist who used a decision aid (DA) to describe prediabetes and four possible options for diabetes prevention; DPP, DPP +/− metformin, metformin only, or usual care. RESULTS/ANTICIPATED RESULTS: Uptake of DPP and/or metformin was higher among SDM participants (n=351) than controls receiving usual care (n = 1,028; 38% vs. 2%, p<.001). At 12-months follow-up, adjusted weight loss (lbs.) was greater among SDM participants than controls (−5.3 vs. −0.2, p < .001). DISCUSSION/SIGNIFICANCE OF IMPACT: A prediabetes SDM intervention led by pharmacists increased patient engagement in evidence-based options for diabetes prevention and was associated with significantly greater uptake of DPP and/or metformin at 4-months and weight loss at 12-months. Prediabetes SDM may be a promising approach to enhance prevention efforts among patients at increased risk.

Type
Clinical Epidemiology/Clinical Trial
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-ncnd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Association for Clinical and Translational Science 2019