Author + information
- Megan Coylewright,
- Elizabeth O'Neill,
- Ariel Sherman,
- Megan J. Gerling,
- Kaavya Adam,
- Keren Xu,
- Stuart W. Grande,
- Harold L. Dauerman and
- Glyn Elwyn
The adoption of shared decision making (SDM) in cardiology practice is difficult. This study investigates the impact of physicians' experience using AS Choice, a decision aid (DA) to help patients with severe aortic stenosis explore options between transcatheter aortic valve replacement and medical therapy, on patient-centered outcomes.
Surveys were conducted at 3 time points, with unique patients at each use: T0 (usual care without DA), T1 (physicians used DA for the first time) and T2 (fifth use). Patient knowledge was obtained via pre- and post-visit surveys. Patient satisfaction and SDM were measured by CAHPS and CollaboRATE, respectively. Comparisons were made by paired t-test and Fisher exact test.
Four physicians and one physician pair (visits held together) participated in the study at two medical centers. Thirty-four patients were included with no patient using DA twice: 25 at T0 (5 per physician), 4 at T1 and 5 at T2. Patients had a mean age of 86.8 years and over half were female. Patients at T2 were significantly older than those at T0 (p=0.03). Patient knowledge increased stepwise from baseline to first use to fifth use, with a significant difference between baseline and multiple uses (p=0.04). Patient satisfaction and SDM also improved with multiple uses (p=0.01 for both). (Figure)
This study suggests a step-wise improvement in patient-centered outcomes with physicians' greater experience using a DA, and may inform future implementation efforts.
Poster Hall, Hall A/B
Sunday, March 11, 2018, 3:45 p.m.-4:30 p.m.
Session Title: How to Implement a Shared Decision Making Approach
Abstract Category: 43. Spotlight on Special Topics: Shared Decision Making
Presentation Number: 1239-111
- 2018 American College of Cardiology Foundation