512-P: Desire for and Experience of Shared Decision-Making and Associations with Patient-Reported Outcomes in Those with Diabetes

Diabetes can be associated with distress and perceived treatment burden, which are more common among low-income and non-white populations and act as barriers to good health and quality of life. Interventions that focus on patient participation, such as shared decision-making (SDM), have been shown to improve diabetes outcomes. We sought to understand how participation in SDM is correlated with treatment burden, diabetes-related distress, patient perceived care quality, and diabetes self-management in adults with type II diabetes, and whether a patient’s desire for SDM influences those relationships. We recruited patients from six county hospital primary care clinics to complete a survey with items from validated scales for each of the above concepts along with demographics. We dichotomized responses based on median scores on the Desire to Participate in Shared Decision-Making (DPMD) scale and the Health Care Climate Questionnaire (HCCQ), a measure of the experience of SDM. We created 4 groups by high/low desire for and high/low experience of SDM, then compared mean scores for diabetes distress, perceived self-management, treatment burden, and care quality between the 4 groups using ANOVA. Of 194 respondents, average age was 54.5, with 63% identifying as female, 35% as white, 45% as Black or African-American, and 20% as of Hispanic or Latin origin. Those with high experience of SDM had significantly lower scores for diabetes distress and treatment burden and significantly higher scores for perceived care quality and self-management, regardless of their desire for SDM. Our findings suggest that SDM may be important for mitigating patient distress and treatment burden and improving self-management and satisfaction with care in a low-income minority population. Further research to explore a causal relationship is vital.