Evidence map›Paper›PMID 33992088›Full record

Trial reportBMC family practice2021

Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care-results of the cluster-randomised controlled DEBATE trial.

Anja Wollny, Christin Löffler, Eva Drewelow, Attila Altiner, Christian Helbig, Anne Daubmann, Karl Wegscheider, Susanne Löscher, Michael Pentzek, Stefan Wilm and 2 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
6.1field-weighted citation impact, top 4% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Anja WollnyInstitute of General Practice, Rostock University Medical Centre, Doberaner Str. 142, 18057, Rostock, Germany.
Christin LöfflerInstitute of General Practice, Rostock University Medical Centre, Doberaner Str. 142, 18057, Rostock, Germany. christin.loeffler@med.uni-rostock.de.ORCID 0000-0001-5763-7588
Eva DrewelowInstitute of General Practice, Rostock University Medical Centre, Doberaner Str. 142, 18057, Rostock, Germany.
Attila AltinerInstitute of General Practice, Rostock University Medical Centre, Doberaner Str. 142, 18057, Rostock, Germany.
Christian HelbigInstitute of General Practice, Rostock University Medical Centre, Doberaner Str. 142, 18057, Rostock, Germany.
Anne DaubmannInstitute of Medical Biometry and Epidemiology, Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Karl WegscheiderInstitute of Medical Biometry and Epidemiology, Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Susanne LöscherInstitute of General Practice (Ifam), Medical Faculty, Centre for Health & Society (Chs), Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Michael PentzekInstitute of General Practice (Ifam), Medical Faculty, Centre for Health & Society (Chs), Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Stefan WilmInstitute of General Practice (Ifam), Medical Faculty, Centre for Health & Society (Chs), Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Gregor FeldmeierInstitute of General Practice, Rostock University Medical Centre, Doberaner Str. 142, 18057, Rostock, Germany.
Sara SantosInstitute of General Practice (Ifam), Medical Faculty, Centre for Health & Society (Chs), Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
University of Rostock · DEHeinrich Heine University Düsseldorf · DEUniversität Hamburg · DE

Funding

Bundesministerium für Bildung und Forschung 01GX1041A
6 · The paper itself

Abstract

backgroundWe investigate whether an educational intervention of GPs increases patient-centeredness and perceived shared decision making in the treatment of patients with poorly controlled type 2 diabetes mellitus?

methodsWe performed a cluster-randomized controlled trial in German primary care. Patients with type 2 diabetes mellitus defined as HbA1c levels ≥ 8.0% (64 mmol/mol) at the time of recruitment (n = 833) from general practitioners (n = 108) were included. Outcome measures included subjective shared decision making (SDM-Q-9; scale from 0 to 45 (high)) and patient-centeredness (PACIC-D; scale from 1 to 5 (high)) as secondary outcomes. Data collection was performed before intervention (baseline, T0), at 6 months (T1), at 12 months (T2), at 18 months (T3), and at 24 months (T4) after baseline.

resultsSubjective shared decision making decreased in both groups during the course of the study (intervention group: -3.17 between T0 and T4 (95% CI: -4.66, -1.69; p < 0.0001) control group: -2.80 (95% CI: -4.30, -1.30; p = 0.0003)). There were no significant differences between the two groups (-0.37; 95% CI: -2.20, 1.45; p = 0.6847). The intervention's impact on patient-centeredness was minor. Values increased in both groups, but the increase was not statistically significant, nor was the difference between the groups.

conclusionsThe intervention did not increase patient perceived subjective shared decision making and patient-centeredness in the intervention group as compared to the control group. Effects in both groups might be partially attributed to the Hawthorne-effect. Future trials should focus on patient-based intervention elements to investigate effects on shared decision making and patient-centeredness.

trial registrationThe trial was registered on March 10

Indexed as

Decision Making, SharedDiabetes Mellitus, Type 2Patient ParticipationDecision MakingHumansPrimary Health CareDecision makingDiabetes mellitus type 2Health communicationHealth services researchPhysician–patient relations

Identifiers

PMID33992088
PMCPMC8126132
OpenAlexW3161887280

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 OpenQuestion graph.