Effect of applying a diabetes risk score on lifestyle counselling and shared decision-making in primary care: A pragmatic cluster randomised trial.

Abstract

There is a lack of studies on the impact of diabetes risk scores on diabetes prevention. The aim of this study was to investigate the effect of applying a non-invasive diabetes risk score as component of routine health checks on counselling intensity and shared decision-making (SDM) in primary care. Cluster randomised trial, in which primary care physicians (n = 30) enrolled participants (n = 315) with statutory health insurance without known diabetes, ≥ 35 years of age with a body mass index (BMI) ≥ 27.0 kg/m². In the intervention group, the German Diabetes Risk Score (GDRS) was applied as add-on to the standard routine health check. Outcomes were length and intensity of the counselling interview and the process of SDM. Analysis was by intention-to-treat using mixed models. In the intervention group, higher odds were found for a more intensive counselling interview regarding physical activity, healthy diet and body weight (e.g., participants` perspective: odds ratios between 1.8 and 2.5) compared to controls. Analysis of total SDM score showed a more participative counselling interview in the intervention than in the control group. GDRS use in routine primary care improves intensity of lifestyle counselling and process of SDM already in people with moderate diabetes risk.