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Background: Guidelines recommend patient engagement in shared decision-making regarding coronary revascularization, but studies demonstrate poor understanding of risks and benefits. Effective strategies are needed to integrate informed patient preferences into clinical care.
Methods: We developed an electronic web-based tool to educate patients and survey their treatment preferences prior to diagnostic angiography. We compared knowledge, attitudes and preferences of 203 patients with and without use of educational materials. Then, interventional cardiologists were randomly assigned to receive vs not receive patient preferences, with subsequent assessment of treatment decisions.
Results: Most patients preferred treatment with PCI compared with either medical therapy (62.6% vs. 21.1%) or CABG (81.2% vs. 6.9%). Web-based education was associated with improved performance on a 6-item knowledge scale, greater interest in shared decision-making, and a trend towards lower decisional conflict (Table), but not an overall change in patient preferences. Preferences were concordant with treatment in only 50% of cases. In the subset of 103 patients receiving education, providing preferences to cardiologists did not impact delivered treatment.
Conclusions: A web-based tool educated patients and integrated preferences into routine cath lab care. A larger randomized study is needed to determine if assessing patient preferences will alter treatment decisions with practicing cardiologists.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Antiplatelet and Antithrombotic Agents in Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1296-312
- 2017 American College of Cardiology Foundation