Effects of patient decision aids in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis

Aims This study aimed to systematically evaluate the effectiveness of patient decision aids on knowledge, decisional conflict and decisional self‐efficacy outcomes in patients with diabetes. Methods A comprehensive database search was performed using the Web of Science, Cochrane Library, PubMed, Embase, PsycINFO (Ovid), CINAHL (EBASCO), CNKI, VIP, Wan Fang Database and the Ottawa Decision Aid Library Inventory (http://decisionaid.ohri.ca/index.html) from inception to 13 October 2019. Two reviewers independently searched databases, screened articles, extracted data and evaluated the risk bias of included studies. Then Rev Man 5.3 software was adopted for statistical analysis. Results Ten articles containing 1,452 people with diabetes were selected. The results of meta‐analysis showed that patient decision aids had a positive effect on reducing decisional conflict and improving decisional self‐efficacy among patients with type 2 diabetes. Meanwhile, this article also revealed that patient decision aids have beneficial short‐term effects on improving knowledge, but there was no significant long‐term effect. Conclusion Patient decision aids are capable of becoming support tools to improve shared decision making. Further implementation studies are required to transform patient decision aids tools into clinical practice. SUMMARY STATEMENT What is already known about this topic? Some patient decision aids have been reported to support patients with diabetes' information processing and decision making. The application of patient decision aids can narrow the knowledge gap between patients and doctors so as to facilitate patient activation. What this paper adds? This article extends the evidence on the beneficial effects of patient decision aids on reducing decisional conflict, improving self‐efficacy and knowledge level among patients with type 2 diabetes mellitus. The review recommends patient decision aids as a supplementary method to promote the quality and effectiveness of decision making for patients with diabetes. The implications of this paper Clinicians could incorporate patient decision aids as part of their clinical consultation, being fully considerate of the patient's preferences.