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BACKGROUND: People with diabetes need to make regular choices that influence their long-term morbidity and mortality. Patient decision aids are validated tools and when used collaboratively between healthcare professionals, patients and carers, can help guide value-based discussions which encourage choices that are well informed and personally relevant. OBJECTIVE: To explore the use and effect of patient decision aids in the management of diabetes. METHOD: A scoping review design was used. Medline, ProQuest, PsycINFO, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases were searched for peer-reviewed articles published between January 1998 and December 2018. RESULTS: Patient decision aids are not commonly or widely used in diabetes management. They offer a suitable adjunct to practice within the domains of healthcare knowledge, active participation, and communication, and shared decision-making between patients and healthcare professionals. CONCLUSION: Patient decision aids can offer a simple and easy-to-use method to potentially improve diabetes health literacy, through the process of shared decision-making and two-way conversations. However, there are current limitations on using them to positively influence clinical outcomes or long-term changes in self-care behaviors within the management of diabetes. Further research to explore the validity of using patient decision aids long term in these areas is required.
RESUMEN
OBJECTIVE: To ensure an efficient publicly funded podiatric service for people with diabetes in regional Victoria, a Podiatry Diabetes Model (PDM) of care was developed. The aim of this study was to determine if people with diabetes attended the most appropriate podiatric service as depicted by the model. METHODS: A 3-month prospective clinical audit of the PDM was undertaken. Primary variables of interest were the podiatric service where the patients were seen and the patients' risk of future foot morbidity. Chi-square analyses for each service category were undertaken to compare the expected number of patients seen according to foot-health risk as predicted by the model, with what was observed. RESULTS: Five hundred and seventy-six people with diabetes were seen in the 3-month period. There was no statistically significant difference between the proportion of patients seen by each podiatric service according to risk status, with what was expected (community: χ(2)=3.3, P=0.4; subacute: χ(2)=8.0, P=0.05; acute: χ(2)=6.6, P=0.09). CONCLUSIONS: The Podiatry Diabetes Model is a sound podiatric model of care and is an example of cross-organisational collaboration that could be implemented in other areas of Australia.
