Development and piloting of four decision aids for implantable cardioverter-defibrillators in different media formats.
defibrillation-implantable cardioverter-defibrillator
heart failure
patient decision aid
qualitative
shared decision making
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
28
08
2021
received:
30
03
2021
accepted:
12
09
2021
pubmed:
17
9
2021
medline:
28
1
2022
entrez:
16
9
2021
Statut:
ppublish
Résumé
Using DAs for preference-sensitive decisions is an evidence-based way to improve patient-centered decisions. Reimbursement mandates have increased the need for DAs in ICD care, although none have been formally evaluated. The objectives were to develop and pilot implantable cardioverter-defibrillator (ICD) decision aids (DAs) for patients considering primary prevention ICDs. Development Phase: An expert panel, including patients and physicians, iteratively developed four DAs: a one-page Option Grid Twenty-one eligible patients enrolled (15 intervention). Most intervention participants found the DAs to be unbiased (67%), helpful (89%), and would recommend them to others (100%). The pilot was feasible at all sites; however, using clinic staff to identify eligible patients was more efficient than chart review. Although the main goals were to measure acceptability and feasibility, intervention participants trended towards increased concordance between longevity values and ICD decisions (71% concordant vs. 29%, p = .06). Participants preferred the in-depth paper tool and video DAs. Access to a nurse during the decision-making window encouraged questions and improved participant-perceived confidence. Participants felt the DAs provided helpful, balanced information that they would recommend to other patients. Further exploration of this larger context of DA use and strategies to promote independent use related to electrophysiology (EP) visits are needed.
Sections du résumé
BACKGROUND
BACKGROUND
Using DAs for preference-sensitive decisions is an evidence-based way to improve patient-centered decisions. Reimbursement mandates have increased the need for DAs in ICD care, although none have been formally evaluated. The objectives were to develop and pilot implantable cardioverter-defibrillator (ICD) decision aids (DAs) for patients considering primary prevention ICDs.
METHODS
METHODS
Development Phase: An expert panel, including patients and physicians, iteratively developed four DAs: a one-page Option Grid
RESULTS
RESULTS
Twenty-one eligible patients enrolled (15 intervention). Most intervention participants found the DAs to be unbiased (67%), helpful (89%), and would recommend them to others (100%). The pilot was feasible at all sites; however, using clinic staff to identify eligible patients was more efficient than chart review. Although the main goals were to measure acceptability and feasibility, intervention participants trended towards increased concordance between longevity values and ICD decisions (71% concordant vs. 29%, p = .06). Participants preferred the in-depth paper tool and video DAs. Access to a nurse during the decision-making window encouraged questions and improved participant-perceived confidence.
CONCLUSIONS
CONCLUSIONS
Participants felt the DAs provided helpful, balanced information that they would recommend to other patients. Further exploration of this larger context of DA use and strategies to promote independent use related to electrophysiology (EP) visits are needed.
Identifiants
pubmed: 34528271
doi: 10.1111/pace.14365
pmc: PMC9272704
mid: NIHMS1816512
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1842-1852Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL153892
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL136403
Pays : United States
Informations de copyright
© 2021 Wiley Periodicals LLC.
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