Changes over Time in Patient Stated Values and Treatment Preferences Regarding Aggressive Therapies: Insights from the DECIDE-LVAD Trial.
Christopher E KnoepkeErin L ChausseeDaniel M MatlockJocelyn S ThompsonColleen K McIlvennanAmrut V AmbardekarElisabeth M SchafferPrateeti KhazanieLaura D SchererRobert M ArnoldLarry A AllenPublished in: Medical decision making : an international journal of the Society for Medical Decision Making (2021)
Most patients considering LVAD were stable in their values and treatment preferences. This stability, as well as the association between unstable treatment preferences and changes to stated values, highlighted the clinical utility of the values scale of aggressiveness. However, a substantial minority reported significant changes over time that may complicate the process of shared decision making. Improved methods to elicit and clarify values, including support to those with depression and low illness acceptance, is critical for patient-centered care.[Box: see text].