Patient-centered care in diabetes care-concepts, relationships and practice

Table 1 Studies reporting controlled trials

Ref.	Country	PCC-related activities	Detailed intervention	Primary outcome	Result summary
Goal setting, SDM
Swoboda et al[1]	United States	Goal setting, SDM	In-person goal setting and decision coaching session to encourage lifestyle change, followed seven biweekly coaching calls delivered by registered dietitian	Diet quality/decision, empowerment, self-efficacy and diabetes-related outcomes	A significant increase in diet quality, decision confidence to achieve diet-related goals, empowerment, self-efficacy, and a significant decrease in diabetes distress and depressive symptoms
Naik et al[2]	United States	Collaborative goal-setting	Healthy Outcomes Through Patient Empowerment (HOPE) group received 9 coaching sessions with a trained health professional: biweekly (for 30-40 min) from months 1 to 3 and monthly (for 15 minutes) from months 4 to 6	A1C level and depression symptoms (Patient Health Questionnaire-9 scores, PHQ-9)	Repeated-measures analysis found no significant improvement in HOPE group in PHQ-9 or A1C compared to enhanced usual care group
Vaughan et al[3]	United States	Collaborative goal-setting	As the interventions above	Diabetes distress levels measured by the Problem Areas in Diabetes (PAID)	Between-group analysis revealed greater improvements in HOPE for PAID total score, emotional, and social subscales compared to enhanced usual care group
Woodard et al[4]	United States	Collaborative Goal Setting	Empowering Patients in Chronic Care (EPICC) participants attended 6 bimonthly group sessions and motivational interview during a 3-month period	A1C level	EPICC group is significant improvements in A1C levels compared to enhanced usual care group
SDM, communication and education, goal setting
Wollny et al[5]	German	SDM, patient-centered communication, shared goal setting	General practitioners (GPs) were encouraged to evaluate their patients’ views, attitudes, and behaviors; An electronic decision-aid was provided to GPs to increase SDM	A1C level	The intervention and the control group the decline of the A1C level was statistically significant. However, there was no statistically significant difference between both groups
Family/caregivers/close friends/peer group involvement and support, communication and education
Castillo-Hernandez et al[6]	Mexico	Peer support	All participants and peer leaders (PLs) attended a four-month Diabetes Self-Management Education (DSME) delivered by a dietitian and diabetes educator. Participants in the peer support and DSME Group (PSEG) attended peer support meetings facilitated by PLs for 8 months	A1C level, quality of life	The PSEG group had a more pronounced clinical improvement, but no statistical improvement, in A1C compared to the education-only group. PSEG participants exhibited statistically significant improvement in diabetes-related quality of life
Rosland et al[7]	United States	Patient-family dyads	Dyads assigned to the CO-IMPACT arm received a health coaching session focused on dyadic information sharing and positive support techniques, then 12 months of biweekly automated monitoring telephone calls to prompt dyadic actions	Patient Activation Measure-13 (PAM-13) and United Kingdom Prospective Diabetes Study (UKPDS) 5-year diabetes-specific cardiac event risk scores	CO-IMPACT patients had greater improvements in PAM-13 scores but nonsignificant differences in UKPDS cardiac risk compared to standard care

PCC: Patient-centered care; SDM: Shared decision making; A1C: Hemoglobin A1C.