Evidence mapPaperPMID 34499328Full record

Trial reportEndocrine2022

Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.

Marleen Kunneman, Megan E Branda, Jennifer L Ridgeway, Kristina Tiedje, Carl R May, Mark Linzer, Jonathan Inselman, Angela L H Buffington, Jordan Coffey, Deborah Boehm and 16 more

Erratum issued 2 registry-linked trialsOpen access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Endocrine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 13 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 6 pooled it
7.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01293578 nacompletednot on this map

Translating Information on Comparative Effectiveness Into Practice (TRICEP)

TypeinterventionalSponsorMayo ClinicRan2011 to 2015Enrolled550ConditionsType 2 Diabetes MellitusArmsDiabetes Medication Choice Cards
NCT01502891 nacompletednot on this map

Translation of Comparative Effectiveness of Depression Medications Into Practice

TypeinterventionalSponsorVictor MontoriRan2011 to 2013Enrolled301ConditionsDepressionArmsDecision Aid
3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 6 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Article
  9. A Quantitative Study Exploring and Comparing Key Factors in Medication Management in the Irish Healthcare Setting.Health expectations : an international journal of public participation in health care and health policy · 2025
    Article
  10. Patient Characteristics and the Extent to Which Clinicians Involve Patients in Decision Making: Secondary Analyses of Pooled Data.Medical decision making : an international journal of the Society for Medical Decision Making · 2024
    Article
  11. Article
  12. Article
  13. Problem-based shared decision making: The role of canonical SDM steps.Health expectations : an international journal of public participation in health care and health policy · 2023
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

26 authors at 11 institutions in 5 countries.

Marleen KunnemanKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0001-5334-1085
Megan E BrandaKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.
Jennifer L RidgewayDivision of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Kristina TiedjeLaboratoire d'anthropologie des enjeux contemporains, Lyon, France.
Carl R MayFaculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Mark LinzerDepartment of Medicine, Hennepin Healthcare and University of Minnesota, Minneapolis, MN, USA.
Jonathan InselmanDivision of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Angela L H BuffingtonDepartment of Psychiatry and Psychology, Mayo Clinic Health System, Mankato, MN, USA.
Jordan CoffeyPractice-Based Research Network, Mayo Clinic, Rochester, MN, US.
Deborah BoehmCenter for Patient and Provider Experience, Hennepin County Medical Center, Minneapolis, MN, USA.
James DemingMayo Clinic Health System Northwest Wisconsin, (dept) Home Health and Hospice, Eau Claire, WI, USA.
Sara DickKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.
Holly van HoutenDivision of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Annie LeBlancKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.
Juliette LiesingerDivision of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Janet LimaPark Nicollet International Diabetes Center, St. Louis Park, MN, USA.
Joanne NordeenMayo Clinic Health System, La Crosse, WI, US.
Laurie PencilleKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.
Sara PoplauOffice of Professional Worklife, Hennepin Healthcare, Minneapolis, MN, USA.
Steven ReedDepartment of Internal Medicine, Park Nicollet Clinic, Brooklyn Center, MN, USA.
Anna VannelliPark Nicollet International Diabetes Center, St. Louis Park, MN, USA.
Kathleen J YostDivision of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Jeanette Y ZiegenfussDivision of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Steven A SmithDivision of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.
Victor M MontoriKnowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.
Nilay D ShahDivision of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. Shah.Nilay@mayo.edu.
Mayo Clinic in Florida · USMayo Clinic in Arizona · USMayo Clinic Health System · USPark Nicollet Clinic · USMayo Clinic · USUniversity of Minnesota · USColorado School of Public Health · USCommunauté urbaine de Lyon · FRHennepin Healthcare Research Institute · USLeiden University Medical Center · NLLondon School of Hygiene & Tropical Medicine · GB

Funding

AHRQ HHS R18 HS018339
6 · The paper itself

Abstract

purposeTo determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making.

methodsIn this mixed methods multicenter cluster randomized trial, we included patients with type 2 diabetes mellitus and their primary care clinicians. We compared usual care with or without a within-encounter SDM conversation aid. We assessed participant-reported decisions made and quality of SDM (knowledge, satisfaction, and decisional conflict), clinical outcomes, adherence, and observer-based patient involvement in decision-making (OPTION12-scale). We used semi-structured interviews with patients to understand their perspectives.

resultsWe enrolled 350 patients and 99 clinicians from 20 practices and interviewed 26 patients. Use of the conversation aid increased post-encounter patient knowledge (correct answers, 52% vs. 45%, p = 0.02) and clinician involvement of patients (Mean between-arm difference in OPTION12, 7.3 (95% CI 3, 12); p = 0.003). There were no between-arm differences in treatment choice, patient or clinician satisfaction, encounter length, medication adherence, or glycemic control. Qualitative analyses highlighted differences in how clinicians involved patients in decision making, with intervention patients noting how clinicians guided them through conversations using factors important to them.

conclusionsUsing an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence or improved diabetes control in patients with type 2 diabetes. Future interventions may need to focus specifically on patients with signs of poor treatment fit. CLINICAL

trial registrationClinicalTrial.gov: NCT01502891.

Indexed as

Diabetes Mellitus, Type 2Decision MakingDecision Support TechniquesHumansMedication AdherencePatient ParticipationDecision aidsDiabetesPatient-centered carePatient–clinician communicationShared decision making

Identifiers

PMID34499328
PMCPMC8428215
OpenAlexW3197822339

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.