Pengaruh Pengambilan Keputusan Bersama terhadap Kadar Glukosa dan HbA1c pada Pasien Diabetes Mellitus: Tinjauan Literatur
Bilah Samping Artikel
Isi Artikel Utama
Page: 1682-1689
Abstrak
Latar Belakang: Diabetes melitus (DM) merupakan penyakit kronis dengan prevalensi tinggi secara global, yang memerlukan pendekatan perawatan komprehensif dan berpusat pada pasien. Shared Decision Making (SDM) atau pengambilan keputusan bersama merupakan pendekatan kolaboratif antara pasien dan tenaga kesehatan yang telah dikaitkan dengan peningkatan kepatuhan terapi dan luaran klinis pada penyakit kronis. Tujuan: Tinjauan literatur ini bertujuan untuk mengevaluasi pengaruh SDM terhadap kendali glikemik, khususnya kadar glukosa darah dan HbA1c pada pasien diabetes melitus. Metode: Pencarian literatur dilakukan secara sistematis melalui basis data PubMed dan Scopus menggunakan kata kunci tertentu, dibatasi pada studi uji klinis acak (RCT) berbahasa Inggris yang diterbitkan antara tahun 2015 hingga 2025. Kriteria inklusi meliputi pasien dewasa dengan DM tipe 1 atau tipe 2, intervensi utama berupa SDM, serta luaran klinis berupa kadar HbA1c atau glukosa darah. Hasil: Sebanyak lima RCT memenuhi kriteria inklusi. Mayoritas studi melaporkan penurunan kadar HbA1c pada kelompok intervensi, meskipun hanya satu studi yang menunjukkan penurunan bermakna secara statistik dalam kelompok tersebut. Tidak ditemukan perbedaan signifikan yang konsisten antara kelompok intervensi dan kontrol. Namun demikian, SDM dikaitkan secara positif dengan peningkatan keterlibatan pasien, kepuasan, dan kualitas komunikasi klinis. Kesimpulan: Meskipun bukti mengenai dampak langsung SDM terhadap kadar HbA1c masih belum konsisten, pendekatan ini terbukti meningkatkan partisipasi pasien dan komunikasi terapeutik dalam perawatan diabetes. Diperlukan penelitian lebih lanjut yang terstandarisasi dan berdurasi panjang untuk memastikan efektivitas klinisnya.
Unduhan
Rincian Artikel
Artikel ini berlisensiCreative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Referensi
IDF. Five questions on the IDF Diabetes Atlas. Diabetes Research and Clinical Practice 2021;102:1–141. https://doi.org/10.1016/j.diabres.2013.10.013. DOI: https://doi.org/10.1016/j.diabres.2013.10.013
Trikkalinou A, Papazafiropoulou AK, Melidonis A. Type 2 diabetes and quality of life. World Journal of Diabetes 2017;8:120. https://doi.org/10.4239/wjd.v8.i4.120. DOI: https://doi.org/10.4239/wjd.v8.i4.120
Hoque F. Shared Decision-Making in Patient Care: Advantages, Barriers and Potential Solutions. Journal of Brown Hospital Medicine 2024;3:13–5. https://doi.org/10.56305/001c.122787.
Stiggelbout AM, Van Der Weijden T, De Wit MPT, Frosch D, Légaré F, Montori VM, et al. Shared decision making: Really putting patients at the centre of healthcare. BMJ (Online) 2012;344:1–6. https://doi.org/10.1136/bmj.e256.
Stacey D, Lewis KB, Smith M, Carley M, Volk R, Douglas EE, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 2024;2024. https://doi.org/10.1002/14651858.CD001431.pub6. DOI: https://doi.org/10.1002/14651858.CD001431.pub6
Joosten EAG, DeFuentes-Merillas L, de Weert GH, Sensky T, van der Staak CPF, de Jong CAJ. Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychotherapy and Psychosomatics 2008;77:219–26. https://doi.org/10.1159/000126073. DOI: https://doi.org/10.1159/000126073
Perron ME, Hudon C, Roux-Levy PH, Poitras ME. Shared decision-making with patients with complex care needs: a scoping review. BMC Primary Care 2024;25. https://doi.org/10.1186/s12875-024-02633-9. DOI: https://doi.org/10.1186/s12875-024-02633-9
Oshima Lee E, Emanuel EJ. Shared decision making to improve care and reduce costs. The New England Journal of Medicine 2013;368:6–8. https://doi.org/10.1056/NEJMp1209500. DOI: https://doi.org/10.1056/NEJMp1209500
Geta ET, Terefa DR, Hailu WB, Olani W, Merdassa E, Dessalegn M, et al. Effectiveness of shared decision-making for glycaemic control among type 2 diabetes mellitus adult patients: A systematic review and meta-analysis. PLoS ONE 2024;19:1–23. https://doi.org/10.1371/journal.pone.0306296. DOI: https://doi.org/10.1371/journal.pone.0306296
Légaré F, Adekpedjou R, Stacey D, Turcotte S, Kryworuchko J, Graham ID, et al. Interventions for increasing the use of shared decision making by healthcare professionals. The Cochrane Database of Systematic Reviews 2018;7:CD006732. https://doi.org/10.1002/14651858.CD006732.pub4.
Wollny A, Altiner A, Daubmann A, Drewelow E, Helbig C, Löscher S, et al. Patient-centered communication and shared decision making to reduce HbA1c levels of patients with poorly controlled type 2 diabetes mellitus - Results of the cluster-randomized controlled DEBATE trial. BMC Family Practice 2019;20:1–11. https://doi.org/10.1186/s12875-019-0977-9.
Lauffenburger JC, Ghazinouri R, Jan S, Makanji S, Ferro CA, Lewey J, et al. Impact of a novel pharmacist-delivered behavioral intervention for patients with poorly-controlled diabetes: The ENhancing outcomes through Goal Assessment and Generating Engagement in Diabetes Mellitus (ENGAGE-DM) pragmatic randomized trial. PLoS ONE 2019;14:1–15. https://doi.org/10.1371/journal.pone.0214754. DOI: https://doi.org/10.1371/journal.pone.0214754
Den Ouden H, Vos RC, Rutten GEHM. Effectiveness of shared goal setting and decision making to achieve treatment targets in type 2 diabetes patients: A cluster-randomized trial (OPTIMAL). Health Expectations 2017;20:1172–80. https://doi.org/10.1111/hex.12563. DOI: https://doi.org/10.1111/hex.12563
Huang ES, Nathan AG, Cooper JM, Lee SM, Shin N, John PM, et al. Impact and Feasibility of Personalized Decision Support for Older Patients with Diabetes: A Pilot Randomized Trial. Med Decis Making 2017;37:611–7. https://doi.org/10.1177/0272989X16654142.
Ruissen MM, Torres-Peña JD, Uitbeijerse BS, de Larriva AP, Huisman SD, Namli T, et al. Clinical impact of an integrated e-health system for diabetes self-management support and shared decision making (POWER2DM): a randomised controlled trial. Diabetologia 2023;66:2213 – 2225. https://doi.org/10.1007/s00125-023-06006-2. DOI: https://doi.org/10.1007/s00125-023-06006-2
Wollny A, Altiner A, Daubmann A, Drewelow E, Helbig C, Löscher S, et al. Patient-centered communication and shared decision making to reduce HbA1c levels of patients with poorly controlled type 2 diabetes mellitus - Results of the cluster-randomized controlled DEBATE trial. BMC Family Practice 2019;20:1–11. https://doi.org/10.1186/s12875-019-0977-9. DOI: https://doi.org/10.1186/s12875-019-0977-9
Xiao T, Wang Z, Li G, Huang S, Zhu X, Liu S, et al. What to do about missed doses? A retrospective study of olanzapine in the elderly. Drug Design, Development and Therapy 2021;15:3411–23. https://doi.org/10.2147/DDDT.S316110. DOI: https://doi.org/10.2147/DDDT.S316110
Huang ES, Nathan AG, Cooper JM, Lee SM, Shin N, John PM, et al. Impact and Feasibility of Personalized Decision Support for Older Patients with Diabetes: A Pilot Randomized Trial. Med Decis Making 2017;37:611–7. https://doi.org/10.1177/0272989X16654142. DOI: https://doi.org/10.1177/0272989X16654142
Stepanian N, Larsen MH, Mendelsohn JB, Mariussen KL, Heggdal K. Empowerment interventions designed for persons living with chronic disease - a systematic review and meta-analysis of the components and efficacy of format on patient-reported outcomes. BMC Health Services Research 2023;23:911. https://doi.org/10.1186/s12913-023-09895-6. DOI: https://doi.org/10.1186/s12913-023-09895-6
Suh WS, Lee CK. Impact of shared-decision making on patient satisfaction. Journal of Preventive Medicine and Public Health 2010;43:26–34. https://doi.org/10.3961/jpmph.2010.43.1.26. DOI: https://doi.org/10.3961/jpmph.2010.43.1.26
Hoque F. Shared Decision-Making in Patient Care: Advantages, Barriers and Potential Solutions. Journal of Brown Hospital Medicine 2024;3:13–5. https://doi.org/10.56305/001c.122787. DOI: https://doi.org/10.56305/001c.122787
Elwyn G, Durand MA, Song J, Aarts J, Barr PJ, Berger Z, et al. A three-talk model for shared decision making: Multistage consultation process. BMJ (Online) 2017;359:1–7. https://doi.org/10.1136/bmj.j4891.
Joseph-Williams N, Lloyd A, Edwards A, Stobbart L, Tomson D, Macphail S, et al. Implementing shared decision making in the NHS: lessons from the MAGIC programme. BMJ (Clinical Research Ed) 2017;357:j1744. https://doi.org/10.1136/bmj.j1744.
Elwyn G, Durand MA, Song J, Aarts J, Barr PJ, Berger Z, et al. A three-talk model for shared decision making: Multistage consultation process. BMJ (Online) 2017;359:1–7. https://doi.org/10.1136/bmj.j4891. DOI: https://doi.org/10.1136/bmj.j4891
Légaré F, Adekpedjou R, Stacey D, Turcotte S, Kryworuchko J, Graham ID, et al. Interventions for increasing the use of shared decision making by healthcare professionals. The Cochrane Database of Systematic Reviews 2018;7:CD006732. https://doi.org/10.1002/14651858.CD006732.pub4. DOI: https://doi.org/10.1002/14651858.CD006732.pub4
Eyth E, Zubair M, Naik R. Hemoglobin A1c. Encyclopedia of Behavioral Medicine 2020:1053–1053. https://doi.org/10.1007/978-3-030-39903-0_300863. DOI: https://doi.org/10.1007/978-3-030-39903-0_300863
American Diabetes Association. Glycemic Targets: Standards of Medical Care in Diabetes. Diabetes Care 2021;44:S73–84. https://doi.org/10.2337/dc21-S006. DOI: https://doi.org/10.2337/dc21-S006
Petrie JR, Guzik TJ, Touyz RM. Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. Canadian Journal of Cardiology 2018;34:575–84. https://doi.org/10.1016/j.cjca.2017.12.005. DOI: https://doi.org/10.1016/j.cjca.2017.12.005
Care D, Suppl SS. Cardiovascular disease and risk management: Standards of medical care in diabetesd 2021. Diabetes Care 2021;44:S125–50. https://doi.org/10.2337/dc21-S010. DOI: https://doi.org/10.2337/dc21-S010
Harati H, Hadaegh F, Saadat N, Azizi F. Population-based incidence of Type 2 diabetes and its associated risk factors: Results from a six-year cohort study in Iran. BMC Public Health 2009;9:1–8. https://doi.org/10.1186/1471-2458-9-186. DOI: https://doi.org/10.1186/1471-2458-9-186
Care D, Suppl SS. Obesity management for the treatment of type 2 diabetes: Standards of medical care in diabetes-2021. Diabetes Care 2021;44:S100–10. https://doi.org/10.2337/dc21-S008. DOI: https://doi.org/10.2337/dc21-S008
Sendekie AK, Netere AK, Kasahun AE, Belachew EA. Medication adherence and its impact on glycemic control in type 2 diabetes mellitus patients with comorbidity: A multicenter cross-sectional study in Northwest Ethiopia. PLoS ONE 2022;17:1–18. https://doi.org/10.1371/journal.pone.0274971. DOI: https://doi.org/10.21203/rs.3.rs-1926873/v1
Kirkman MS, Rowan-Martin MT, Levin R, Fonseca VA, Schmittdiel JA, Herman WH, et al. Determinants of Adherence to Diabetes Medications: Findings from A Large Pharmacy Claims Database. Diabetes Care 2015;38:604–9. DOI: https://doi.org/10.2337/dc14-2098
Strati M, Moustaki M, Psaltopoulou T, Vryonidou A, Paschou SA. Early onset type 2 diabetes mellitus: an update. Endocrine 2024;85:965–78. https://doi.org/10.1007/s12020-024-03772-w. DOI: https://doi.org/10.1007/s12020-024-03772-w
Banday MZ, Sameer AS, Nissar S. Pathophysiology of diabetes: An overview. Avicenna Journal of Medicine 2020;10:174–88. https://doi.org/10.4103/ajm.ajm_53_20. DOI: https://doi.org/10.4103/ajm.ajm_53_20
American Diabetes Association. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes. Diabetes Care 2021;44:S151–67. https://doi.org/10.2337/dc21-S011. DOI: https://doi.org/10.2337/dc21-S011
Care D, Suppl SS. Improving care and promoting health in populations: Standards of medical care in diabetes−2021. Diabetes Care 2021;44:S7–14. https://doi.org/10.2337/dc21-s001. DOI: https://doi.org/10.2337/dc21-S001
Peimani M, Stewart AL, Garmaroudi G, Nasli-Esfahani E. Shared decision-making in type 2 diabetes: a systematic review of patients’ preferences and healthcare providers’ perspectives. BMC Health Services Research 2025;25. https://doi.org/10.1186/s12913-024-12160-z. DOI: https://doi.org/10.1186/s12913-024-12160-z
Stiggelbout AM, Van Der Weijden T, De Wit MPT, Frosch D, Légaré F, Montori VM, et al. Shared decision making: Really putting patients at the centre of healthcare. BMJ (Online) 2012;344:1–6. https://doi.org/10.1136/bmj.e256. DOI: https://doi.org/10.1136/bmj.e256
Joseph-Williams N, Lloyd A, Edwards A, Stobbart L, Tomson D, Macphail S, et al. Implementing shared decision making in the NHS: lessons from the MAGIC programme. BMJ (Clinical Research Ed) 2017;357:j1744. https://doi.org/10.1136/bmj.j1744. DOI: https://doi.org/10.1136/bmj.j1744