TY - JOUR
T1 - Shared Decision Making Tools for People Facing Stroke Prevention Strategies in Atrial Fibrillation
T2 - A Systematic Review and Environmental Scan
AU - Torres Roldan, Victor D.
AU - Brand-McCarthy, Sarah R.
AU - Ponce, Oscar J.
AU - Belluzzo, Tereza
AU - Urtecho, Meritxell
AU - Espinoza Suarez, Nataly R.
AU - Toloza, Freddy J.K.
AU - Thota, Anjali D.
AU - Organick, Paige W.
AU - Barrera, Francisco
AU - Liu-Sanchez, Carolina
AU - Jaladi, Soumya
AU - Prokop, Larry
AU - Ozanne, Elissa M.
AU - Fagerlin, Angela
AU - Hargraves, Ian G.
AU - Noseworthy, Peter A.
AU - Montori, Victor M.
AU - Brito, Juan P.
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2021/7
Y1 - 2021/7
N2 - Objective: Shared decision making (SDM) tools can help implement guideline recommendations for patients with atrial fibrillation (AF) considering stroke prevention strategies. We sought to characterize all available SDM tools for this purpose and examine their quality and clinical impact. Methods: We searched through multiple bibliographic databases, social media, and an SDM tool repository from inception to May 2020 and contacted authors of identified SDM tools. Eligible tools had to offer information about warfarin and ≥1 direct oral anticoagulant. We extracted tool characteristics, assessed their adherence to the International Patient Decision Aids Standards, and obtained information about their efficacy in promoting SDM. Results: We found 14 SDM tools. Most tools provided up-to-date information about the options, but very few included practical considerations (e.g., out-of-pocket cost). Five of these SDM tools, all used by patients prior to the encounter, were tested in trials at high risk of bias and were found to produce small improvements in patient knowledge and reductions in decisional conflict. Conclusion: Several SDM tools for stroke prevention in AF are available, but whether they promote high-quality SDM is yet to be known. The implementation of guidelines for SDM in this context requires user-centered development and evaluation of SDM tools that can effectively promote high-quality SDM and improve stroke prevention in patients with AF.
AB - Objective: Shared decision making (SDM) tools can help implement guideline recommendations for patients with atrial fibrillation (AF) considering stroke prevention strategies. We sought to characterize all available SDM tools for this purpose and examine their quality and clinical impact. Methods: We searched through multiple bibliographic databases, social media, and an SDM tool repository from inception to May 2020 and contacted authors of identified SDM tools. Eligible tools had to offer information about warfarin and ≥1 direct oral anticoagulant. We extracted tool characteristics, assessed their adherence to the International Patient Decision Aids Standards, and obtained information about their efficacy in promoting SDM. Results: We found 14 SDM tools. Most tools provided up-to-date information about the options, but very few included practical considerations (e.g., out-of-pocket cost). Five of these SDM tools, all used by patients prior to the encounter, were tested in trials at high risk of bias and were found to produce small improvements in patient knowledge and reductions in decisional conflict. Conclusion: Several SDM tools for stroke prevention in AF are available, but whether they promote high-quality SDM is yet to be known. The implementation of guidelines for SDM in this context requires user-centered development and evaluation of SDM tools that can effectively promote high-quality SDM and improve stroke prevention in patients with AF.
KW - anticoagulation
KW - atrial fibrillation
KW - cardiovascular prevention
KW - decision aids
KW - shared decision making
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U2 - 10.1177/0272989X211005655
DO - 10.1177/0272989X211005655
M3 - Article
C2 - 33896270
AN - SCOPUS:85104823677
SN - 0272-989X
VL - 41
SP - 540
EP - 549
JO - Medical Decision Making
JF - Medical Decision Making
IS - 5
ER -