Effect of the statin choice encounter decision aid in Spanish patients with type 2 diabetes: A randomized trial

• The encounter decision aid improved knowledge, risk perception and 3-month adherence.
• There were no differences in decisional conflict, anxiety or consultation time.
• The encounter decision aid improved the quality of decision making about statins.
• Statin choice is effective for promoting shared decision making in the Spanish NHS.

ObjectiveStatin choice, an encounter decision aid (DA), was developed in the USA to facilitate shared decision making between patients and clinicians about the use of statins to reduce cardiovascular risk. We aimed to assess the efficacy of this DA, compared to usual primary care, in Spanish patients with type 2 diabetes.MethodsCluster randomized trial with 29 clinicians and 168 patients. Knowledge of statins, cardiovascular risk perception, decisional conflict, anxiety and satisfaction with the decision making process were assessed immediately after intervention, and self-reported adherence at three months.ResultsIntervention significantly improved knowledge (p = 0.01), perception of the 10-year risk of myocardial infarction without (p = 0.01) and with statins (p = 0.08), and satisfaction (p = 0.01). There were no significant differences in decisional conflict, anxiety, consultation time or adherence, although more intervention patients reported taking all pills during the last week (92.7% vs. 81%; p = 0.19).ConclusionThe statin choice DA improved the quality of decision making about statins.Practice implicationsThis trial contributes to the body of evidence substantiating the efficacy of statin choice and extending it to Spanish clinicians and their patients with type 2 diabetes.Trial registrationThis trial is registered with the European Union Clinical Trials Register (EudraCT: 2010-023912-14).