USING MODERN TECHNOLOGY TO SUPPORT DECISION MAKING IN PATIENTS WITH TYPE 2 DIABETES: THE INSULIN DECISION AID WEBSITE
Purpose:
Patient decision aid (PDA) is an evidence-based decision support tool that helps patients in making a decision about their health. Web-based PDAs are increasingly being used for its interactiveness, accessibility and ease of maintenance. However, few studies described their development process. This abstract aimed to document the development process and pilot test an interactive web-based-PDA that support patients with type 2 diabetes in making informed decision about insulin initiation.
Method(s):
Step 1 (Content development): The content of the Web-PDA was developed according to the International Patient Decision Aids Standards and was adapted from the “Making choices: Should I start Insulin?” patient decision aid books (www.dmit.um.edu.my).
Step 2 (Web design): This involved the iterative design of the website. Decision experts, clinicians, information technology experts and the creative designers developed the website through several rounds of discussion.
Step 3 (Pilot testing): The website underwent beta-testing with 13 patients who provided feedback on the website over three cycles until no further changes are suggested by the users. After using the website, the participants completed a questionnaire to feedback about the website feasibility and acceptability.
Result(s):
The content of the final website consists of: information about diabetes; insulin and blood sugar monitoring; addressing common patient concerns; blood sugar and risk of complications; treatment options and their pro and cons (besides insulin); clarifications of patient's personal values; patient support needs; and patient's decision.
The web-based insulin PDA contained the following unique features: animations to explain diabetes and insulin-related concepts; personalized HbA1c chart and risk of complications; visualization of personal concerns and preferences for deliberation of treatment options; personalized pros and cons table of selected treatment options; and a summary sheet for patient's reference and communication with their healthcare professionals.
Majority of the participant thought the website was easy to use, with well integrated functions and they felt very confident in using it. Most would like to use the website frequently and would recommend this decision aid to other patients in similar situation as them. (Table 1)
Conclusion(s):
Step by step development of a Web-based PDA with beta testing is feasible. Majority of the participants' feedback about the feasibility and acceptability of the website were positive.
