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Table 3 Consultation extracts

From: Investigating active ingredients in a complex intervention: a nested study within the Patient and Decision Aids (PANDAs) randomised controlled trial for people with type 2 diabetes

Patient A Nurse OK. We’ll have a look at [PDA] together then and then we’ll go back onto the insulin things.
Patient A Yeah, yeah. [Discussion covering main sections of the PDA, then:]
Nurse Great, yeah. Clearly understood what we’re talking about.
Patient A Yeah, yeah.
Nurse And these are the choices that you’ve got haven’t you?
Patient A Yeah, yeah, they are, yeah.
Nurse So having looked at those choices and taking on board that, you’ve come to a decision -
Patient A Well I think I’ll agree to listen to your concerns as well, you know, because I think you’ve more experience, you know, in sort of dealing with this thing than I have, you know, so if it’s necessary that I need to go on insulin I’m quite prepared to.
B GP How are you getting on?
Patient B I still don’t think I’m any closer to making a decision. I didn’t think I were near enough for that decision yet.
GP So I think we’ve maybe got a bit of scope to increase your medication […] I don’t think you’re absolutely ready to be referred as yet …
C Nurse: How did you find that [PDA], useful?
Patient: Yeah, a couple of times it’s been mentioned to me about going on insulin.
Nurse: Mmm, yes, I know.
Patient: And I’ve always feared it, you know, I’ve feared it
D Nurse And obviously this [PDA] has given you something to think about.
Patient D It doesn’t do a lot for me actually. No. I mean the difference between 22 and 29 -
Nurse But think about – yeah, but if you were one of those three it would be a big difference.
Patient D Yeah, but one of those three could be run over by a bus. I mean that’s what life’s all about. These are probabilities, you know. […] I’m not going to fight statistics.
E Nurse This [PDA] how have you found it? …
Patient E Ok. You know, I'm fairly positive with most things. [discussion follows with reference to diabetes treatments as structured in PDA]
Patient E So it's my diet that's got to be sorted a bit better.
F Patient F: But I just do feel that one of the reasons the tablets are struggling is because all the things I’m not doing - the stuff we discussed earlier [in the PDA].
Nurse: That’s it it’s got to be a bit of everything hasn’t it. It’s got to be the correct medication. Diet. Exercise.
Patient F: I’m gonna go back onto the eating regime I was on in 2002 when I lost all the weight.
G Patient G : But I'm finding tablets ok you know.
Nurse: But ok in what way? Because so far they've not brought your sugar level down…
Patient G : They've not made me feel badly at all.
Nurse: And at the moment what do you think the best plan of action would be? […]
Patient G : Definitely diet yeah.
Nurse: Adapting that a little better, try and get your sugar levels down.
Nurse: [later…] Just going back to this [PDA], is it important for you to get your sugar down?
H GP And really I think we’re going to, you know, need insulin to…
Patient H Yeah, that’s fine.
GP … get it …
Patient H Yeah, let’s get on
GP …nicely under control. Err,… [later…]
GP I’m sure they have…
Patient H Yeah. Been through it.
GP …been through all that. What did you think of the [PDA], was it…?
Patient H Yeah, it was good, yeah.