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The Diabetes Educator, Vol. 33, No. 4, 700-708 (2007)
DOI: 10.1177/0145721707304086

FEATURES

A Shared Decision-Making Primary Care Intervention for Type 2 Diabetes

William Corser, PhD, RN, Margaret Holmes-Rovner, PhD, Catherine Lein, RN, MS, APRN-BC and Ved Gossain, MD

From the College of Nursing (Dr Corser, Dr Holmes-Rovner, Ms Lein) and the Department of Internal Medicine (Dr Gossain), Michigan State University, East Lansing.

Correspondence to William Corser, PhD, RN, Michigan State University, College of Nursing, A109 Life Sciences Building, East Lansing, MI 48824-1317 (bill.corser{at}ht.msu.edu).

Purpose

The purpose of this study is to test the feasibility of a brief shared decision-making (SDM) goal-setting intervention among individuals with type 2 diabetes.

Methods

A convenience sample of 58 patients from the University Internal Medicine Resident Clinic was recruited to participate in the study. Outcomes were tested through a pilot test of the intervention and ongoing conversations with clinic nursing staff and physicians. Patient outcomes included preintervention and postintervention hemoglobin A1C (HbA1c), weight and blood pressure levels, preintervention and postintervention patient survey questionnaires, and documented diabetes goals.

Results

Most providers indicated that the SDM intervention did not impose major demands. Patient-centered interviewing and an SDM approach to goal setting led to 75.9% of patients having at least 1 diabetes management goal documented in their medical record after intervention. HbA1c level, weight, and diabetes empowerment score showed a trend toward improvement, as did patient ratings of "life disruption from having diabetes." Postintervention perceived knowledge of diabetes and treatments increased significantly (P = .001), as did the mean numbers of documented diabetes management goals (P < .001).

Conclusions

An SDM intervention for individuals with type 2 diabetes appears to be feasible and may improve major diabetes outcomes in primary care. SDM workbooks and activities can encourage patients to identify realistic diabetes goals with primary care providers. These results are encouraging. Future randomized trials with larger samples are warranted.


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