Shared Decision Making Tools for People Facing Stroke Prevention Strategies in Atrial Fibrillation: A Systematic Review and Environmental Scan

Victor D. Torres Roldan, Sarah R. Brand-McCarthy, Oscar J. Ponce, Tereza Belluzzo, Meritxell Urtecho, Nataly R. Espinoza Suarez, Freddy J. K. Toloza, Anjali D. Thota, Paige W. Organick, Francisco Barrera, Carolina Liu-Sanchez, Soumya Jaladi, Larry Prokop, Elissa M. Ozanne, Angela Fagerlin, Ian G. Hargraves, Peter A. Noseworthy, Victor M. Montori and Juan P. Brito
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Victor D. Torres Roldan: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Sarah R. Brand-McCarthy: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Oscar J. Ponce: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Tereza Belluzzo: General Medicine, Charles University in Prague, Medical Faculty of Hradec Králové, Hradec Kralove, Czech Republic
Meritxell Urtecho: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Nataly R. Espinoza Suarez: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Freddy J. K. Toloza: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Anjali D. Thota: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Paige W. Organick: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Francisco Barrera: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Carolina Liu-Sanchez: School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
Soumya Jaladi: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Larry Prokop: Department of Library-Public Services, Mayo Clinic, Rochester MN, USA
Elissa M. Ozanne: Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
Angela Fagerlin: Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
Ian G. Hargraves: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Peter A. Noseworthy: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Victor M. Montori: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Juan P. Brito: Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA

Medical Decision Making, 2021, vol. 41, issue 5, 540-549

Abstract: 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.

Keywords: anticoagulation; atrial fibrillation; cardiovascular prevention; decision aids; shared decision making (search for similar items in EconPapers)
Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:41:y:2021:i:5:p:540-549

DOI: 10.1177/0272989X211005655

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