Project Overview +

Successful diabetes management is dependent on the patient - provider partnership. However, a full discussion of potential benefits, harms, costs, and burdens associated with each medication option is often too much for a brief clinic visit. This project uses AHRQ-developed consumer guides as inspiration for a tailored program that assists with this decision-making. The intervention is delivered on iPads by Community Health Workers in participant homes and is available in both English and Spanish.

Aims +

Aim 1. To use the information in the two diabetes medications consumer CERSGs to build an interactive, computer tailored diabetes medication guide that will enable patients to assess their treatment goals, personal preferences, and side-effect concerns and generate a personally tailored assessment of their current diabetes treatments with, as appropriate, options for improving their diabetes care;

Aim 2. To determine the extent to which this personally tailored diabetes medication guide compares with the print consumer guides reduces Latino and African American diabetes patients' decisional conflict, through improved knowledge of anti-hyperglycemic medications and satisfaction with information.

Aim 3. To examine the computer tailored program's effects on participants' changes in medications (medication intensification), self-reported medication adherence and beliefs and A1C levels between baseline and follow-up compared to participants receiving the print consumer guides.

Participants +

Lower-literacy, diabetic African Americans and English or Spanish-speaking Latino adults with poor glycemic control or high medication dissatisfaction

Intervention +

Participants in the intervention spend 1.5-2 hours with a community health worker talking about information in the tailored, web program. The program is tailored on participant values, barriers to medication adherence, medication satisfaction, A1c, in addition to other variables. Participants who express interest in changing their current medication regimen can receive help scheduling an appointment with their physician.

Participants in the control arm spend 1.5-2 hours with a Community Health Worker reviewing non-tailored, paper versions of the AHRQ consumer guides.

Findings +

iDecide

09/30/2010 - 09/29/2013

Sponsor(s)

Agency for Healthcare Research and Quality

Principal Investigator:

M. E. Michele Heisler, MD, MPA

Co-Investigator(s):

Lawrence C. An, MD
Angela Fagerlin, PhD
Victor M. Montori, MD, MSc
Caroline R. Richardson, MD
Michael Spencer, PhD
Melissa A. Valerio, PhD
Sandeep Vijan, MD, MS

Publications: