Effect of the statin choice encounter decision aid in Spanish patients with type 2 diabetes: A randomized trial

Perestelo-Pérez, Lilisbeth; Rivero‐Santana, Amado; Boronat, Mauro; Sánchez-Afonso, Juan A; Pérez-Ramos, Jeanette; Montori, Víctor M.; Serrano‐Aguilar, Pedro

doi:10.1016/j.pec.2015.08.032

Cited by 49 publications

(125 citation statements)

References 27 publications

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“…Luego de realizar una búsqueda sistemática de la literatura, encontramos seis ECA que evaluaron HATD en pacientes con diabetes mellitus [22][23][24][25][26][27] (Tabla 1). En general, estos estudios confirmaron los resultados de la revisión Cochrane.…”

Section: El Desafío Es La Situaciónunclassified

“…Nuestro grupo de investigación ha desarrollado dos HATD específicamente para los pacientes con diabetes mellitus 22,[24][25][26][27] las que están disponibles online con libre acceso (http://shareddecisions. mayoclinic.org/).…”

Section: El Desafío Es La Situaciónunclassified

“…primaria para un paciente diabético 22,24,26,27 . La tarjeta presenta el riesgo cardiovascular a 10 años del paciente según sus características y la reducción de riesgo asociado al tomar una estatina (Figura 2).…”

Section: El Desafío Es La Situaciónunclassified

“…Además, presenta aspectos importantes para el paciente, como posibles efectos adversos, rutina diaria y costo. Ambas herramientas han demostrado beneficios en diversos ECA en Estados Unidos de Norteamérica 22,24-26 y España 27 , aumentando el grado de conocimiento en los pacientes, la proporción de pacientes que entendieron su riesgo de complicaciones y la probabilidad de beneficio con el tratamiento, y la proporción de pacientes que participaron activamente en la toma de decisión.…”

Section: El Desafío Es La Situaciónunclassified

“…Es necesario seguir investigando nuevos méto-dos y herramientas que apoyen la TDC, sobre todo en países latinoamericanos, donde la evidencia aún es escasa y el contexto social y político es particular y dinámico 27 . Hace falta mayor investigación que explore las situaciones que se benefician de TDC y las formas en que debería practicarse, así como una mayor cantidad de estudios con un número de pacientes y un tiempo de seguimiento adecuados para poder determinar el rol de TDC en adherencia y resultados clínicos.…”

Section: Futuro De La Tdc En El Cuidado De Las Personas Que Viven Conunclassified

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Toma de decisiones compartidas en la atención de pacientes con diabetes mellitus: un desafío para Latinoamérica

et al. 2017

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Section: El Desafío Es La Situaciónunclassified

Section: Futuro De La Tdc En El Cuidado De Las Personas Que Viven Conunclassified

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Toma de decisiones compartidas en la atención de pacientes con diabetes mellitus: un desafío para Latinoamérica

et al. 2017

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Shared Decision-Making in Cardiovascular Risk Factor Management

Elias,

Chen,

Liu

et al. 2024

JAMA Netw Open

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ImportanceThe effect of shared decision-making (SDM) and the extent of its use in interventions to improve cardiovascular risk remain unclear.ObjectiveTo assess the extent to which SDM is used in interventions aimed to enhance the management of cardiovascular risk factors and to explore the association of SDM with decisional outcomes, cardiovascular risk factors, and health behaviors.Data SourcesFor this systematic review and meta-analysis, a literature search was conducted in the Medline, CINAHL, Embase, Cochrane, Web of Science, Scopus, and ClinicalTrials.gov databases for articles published from inception to June 24, 2022, without language restrictions.Study SelectionRandomized clinical trials (RCTs) comparing SDM-based interventions with standard of care for cardiovascular risk factor management were included.Data Extraction and SynthesisThe systematic search resulted in 9365 references. Duplicates were removed, and 2 independent reviewers screened the trials (title, abstract, and full text) and extracted data. Data were pooled using a random-effects model. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline.Main Outcomes and MeasuresDecisional outcomes, cardiovascular risk factor outcomes, and health behavioral outcomes.ResultsThis review included 57 RCTs with 88 578 patients and 1341 clinicians. A total of 59 articles were included, as 2 RCTs were reported twice. Nearly half of the studies (29 [49.2%]) tested interventions that targeted both patients and clinicians, and an equal number (29 [49.2%]) exclusively focused on patients. More than half (32 [54.2%]) focused on diabetes management, and one-quarter focused on multiple cardiovascular risk factors (14 [23.7%]). Most studies (35 [59.3%]) assessed cardiovascular risk factors and health behaviors as well as decisional outcomes. The quality of studies reviewed was low to fair. The SDM intervention was associated with a decrease of 4.21 points (95% CI, −8.21 to −0.21) in Decisional Conflict Scale scores (9 trials; I2 = 85.6%) and a decrease of 0.20% (95% CI, −0.39% to −0.01%) in hemoglobin A1c (HbA1c) levels (18 trials; I2 = 84.2%).Conclusions and RelevanceIn this systematic review and meta-analysis of the current state of research on SDM interventions for cardiovascular risk management, there was a slight reduction in decisional conflict and an improvement in HbA1c levels with substantial heterogeneity. High-quality studies are needed to inform the use of SDM to improve cardiovascular risk management.

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