Van evidencebased medicine naar shared decision-making bij diabetes mellitus

Abstract

From evidence-based medicine to shared decision-making in diabetes mellitus Diabetes mellitus (DM) is a chronic disease with a worldwide prevalence of more than 450 million people. It is estimated that only 14.3% of this population achieves the targets with regard to HbA1c, blood pressure and cholesterol levels. DM prevention and management are getting more and more attention. Thanks to shared decision-making (SDM), the patient’s personal context can be identified and therapy can be adjusted if needed. Currently, there is little guidance for physicians on how they should implement SDM in practice. Healthcare organizations can play a role in providing education to support the use of SDM. Various barriers such as time pressure, paternalism and ignorance hamper the use of SDM. New technologies are making it increasingly easy to exchange information between doctors and patients in a patient-friendly manner. Given the actual increase of patient participation in practice, SDM will become increasingly important. From an ethical point of view, patient education is necessary in order to achieve complete autonomy of the patient and to enable SDM. The diabetes educator plays an important role to achieve this, complemented by the use of technological tools that become more and more available such as apps, web-based applications, continuous glucose monitoring, etc. SDM has the opportunity to combine an ethical approach with scientific evidence and consequently transforming care in making the best decision for each patient.