Dataset Information

Use of the analytic hierarchy process for medication decision-making in type 2 diabetes.

ABSTRACT:

Aim

To investigate the feasibility and utility of the Analytic Hierarchy Process (AHP) for medication decision-making in type 2 diabetes.

Methods

We conducted an AHP with nine diabetes experts using structured interviews to rank add-on therapies (to metformin) for type 2 diabetes. During the AHP, participants compared treatment alternatives relative to eight outcomes (hemoglobin A1c-lowering and seven potential harms) and the relative importance of the different outcomes. The AHP model and instrument were pre-tested and pilot-tested prior to use. Results were discussed and an evaluation of the AHP was conducted during a group session. We conducted the quantitative analysis using Expert Choice software with the ideal mode to determine the priority of treatment alternatives.

Results

Participants judged exenatide to be the best add-on therapy followed by sitagliptin, sulfonylureas, and then pioglitazone. Maximizing benefit was judged 21% more important than minimizing harm. Minimizing severe hypoglycemia was judged to be the most important harm to avoid. Exenatide was the best overall alternative if the importance of minimizing harms was prioritized completely over maximizing benefits. Participants reported that the AHP improved transparency, consistency, and an understanding of others' perspectives and agreed that the results reflected the views of the group.

Conclusions

The AHP is feasible and useful to make decisions about diabetes medications. Future studies which incorporate stakeholder preferences should evaluate other decision contexts, objectives, and treatments.

SUBMITTER: Maruthur NM

PROVIDER: S-EPMC4441461 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

Use of the analytic hierarchy process for medication decision-making in type 2 diabetes.

Maruthur Nisa M NM Joy Susan M SM Dolan James G JG Shihab Hasan M HM Singh Sonal S

PloS one 20150522 5

<h4>Aim</h4>To investigate the feasibility and utility of the Analytic Hierarchy Process (AHP) for medication decision-making in type 2 diabetes.<h4>Methods</h4>We conducted an AHP with nine diabetes experts using structured interviews to rank add-on therapies (to metformin) for type 2 diabetes. During the AHP, participants compared treatment alternatives relative to eight outcomes (hemoglobin A1c-lowering and seven potential harms) and the relative importance of the different outcomes. The AHP ...[more]

PMID: 26000636

Similar Datasets

Project description:OBJECTIVE:To assess the efficacy of the Diabetes Medication Choice Decision Aid among patients with type 2 diabetes in Greece. DESIGN:Open-label cluster randomised controlled trial. SETTING:Primary and secondary care practices across Greece. PARTICIPANTS:5 sites allocated to the decision aid (n=101 patients) and 4 sites to control (n=103 patients). INTERVENTION:Clinicians and patients in the intervention arm used a decision aid, based on outcomes that both consider important when choosing among antihyperglycaemic medications. Patients in the control arm received usual care. OUTCOME MEASURES:The primary outcome was patient's level of decisional comfort after the initial clinical encounter. Secondary outcomes included patient's knowledge about type 2 diabetes and medications, and patient's and clinician's satisfaction. Adherence to prescribed antihyperglycaemic medication and change in glycated haemoglobin were assessed at 24?weeks. RESULTS:Patients in both arms had similar scores in overall decisional comfort (mean difference between the usual care and decision aid arms -6.9, 95% CI -21.5 to 7.7) and its subscales. Patients' knowledge was high in both arms (mean difference 2.3%, 95% CI -15.7% to 20.4%). Patients and clinicians in both groups were equally satisfied with the decision-making. No significant difference in medication adherence and glycaemic control was found across arms. Clinicians found the decision aid useful and reported that its integration in their daily routine was easy. CONCLUSIONS:The decision aid was implemented and positively received in the clinical setting in Greece, in line with the patient-centred approach endorsed by current guidelines. However, this trial yielded imprecise results in terms of patient outcomes. Further research is needed to investigate the interaction between the patient and the clinician in order to clarify the association between the use of decision aids and implementation of shared decision-making. TRIAL REGISTRATION NUMBER:NCT01861756. Pre-results.

Dataset Information

Use of the analytic hierarchy process for medication decision-making in type 2 diabetes.

Aim

Methods

Results

Conclusions

Publications

Use of the analytic hierarchy process for medication decision-making in type 2 diabetes.

Similar Datasets

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