McBride, E;
Hacking, B;
O'Carroll, R;
Young, M;
Jahr, J;
Borthwick, C;
Callander, A;
(2016)
Increasing patient involvement in the diabetic foot pathway: a pilot randomized controlled trial.
Diabetic Medicine
, 33
(11)
pp. 1483-1492.
10.1111/dme.13158.
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Abstract
Aims This pilot study aimed to explore whether the use of an intervention to increase shared decision-making (Decision Navigation) increased decision self-efficacy and foot-treatment adherence in patients with a diabetic foot ulcer. Methods Fifty-six patients with a diabetic foot ulcer were randomized to receive Decision Navigation (N = 30) or usual care (N = 26). Primary outcomes included decision self-efficacy, adherence to foot treatment as reported by the participant and adherence to foot treatment as reported by the clinician. Secondary outcomes included foot ulcer healing rate, health-related quality of life, decision conflict and decision regret. Results Despite participants rating Decision Navigation as very helpful, mixed analyses of variance revealed no differences in decision self-efficacy or adherence between those receiving Decision Navigation and those receiving usual care. There were no differences between groups with regards to the secondary outcomes, with the exception of decision conflict which increased over time (12 weeks) for those receiving Decision Navigation. Conclusions An intervention that facilitated patient involvement in treatment decisions did not have any impact on decisional confidence or adherence to foot treatment. This does not provide support for the suggestion that personalized care can improve health-related outcomes at this progressed stage of the patient's disease trajectory. We suggest that the diabetic foot population may benefit from interventions aimed at increasing motivation to engage with care pathways, centred on challenging personal controllability beliefs.
| Type: | Article |
|---|---|
| Title: | Increasing patient involvement in the diabetic foot pathway: a pilot randomized controlled trial |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/dme.13158 |
| Publisher version: | http://doi.org/10.1111/dme.13158 |
| Language: | English |
| Additional information: | Copyright © 2017 Diabetes UK. All rights reserved. This is the peer reviewed version of the following article: McBride, E; Hacking, B; O'Carroll, R; Young, M; Jahr, J; Borthwick, C; Callander, A; (2016) Increasing patient involvement in the diabetic foot pathway: a pilot randomized controlled trial. Diabetic Medicine , 33 (11) pp. 1483-1492, which has been published in final form at http://doi.org/10.1111/dme.13158. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1527016 |
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