Evaluating the Effect of a Patient Decision Aid for Atrial Fibrillation Stroke Prevention Therapy.
Peter S LoewenNick BansbackJames HicklinJason G AndradeAnita I KapanenLeanne KwanLarry D LyndAlison McCleanJenny MacGillivrayShahrzad SalmasiPublished in: The Annals of pharmacotherapy (2019)
37 participants completed the PDA. The PDA could be completed independently and was well accepted. It significantly decreased the mean decisional conflict score ( P < 0.001) and all its subscales and increased participant AF knowledge ( P = 0.02). 76% of participants indicated that their individualized therapy attribute ranking was congruent with their values. The PDA-generated best-match therapy was chosen by 70% of participants in decision 1 (no therapy, aspirin, or oral anticoagulant), and 17% for decision 2 (choice of anticoagulant). Among AF patients, 60% chose a different drug than that currently prescribed to them. Conclusion and Relevance: Our PDA was effective for reducing decisional conflict, increasing patient knowledge, eliciting patients' values, and presenting therapy options that aligned with patients' values and preferences. Using the PDA revealed that many patients have therapy preferences different from their currently prescribed treatment. The PDA is a practical and potentially valuable tool to facilitate decision making about stroke prevention therapy for AF.
Keyphrases
- atrial fibrillation
- end stage renal disease
- decision making
- ejection fraction
- newly diagnosed
- chronic kidney disease
- healthcare
- prognostic factors
- stem cells
- case report
- cardiovascular disease
- heart failure
- type diabetes
- low dose
- patient reported outcomes
- patient reported
- smoking cessation
- cardiovascular events
- blood brain barrier