Shared decision-making tool for thromboprophylaxis in atrial fibrillation - A feasibility study

American Heart Journal
Mark H EckmanJohn Kues

Abstract

Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. We hypothesized that a shared decision-making interaction facilitated by an Atrial Fibrillation Shared Decision Making Tool (AFSDM) would improve patient knowledge about atrial fibrillation, and the risks and benefits of various treatment options for stroke prevention; increase satisfaction with the decision-making process; improve the therapeutic alliance between patient and the clinical care team; and increase medication adherence. Using a pre- and post-visit study design, we enrolled 76 patients and completed 2 office visits and 1-month telephone follow-up for 65 patients being seen in our Arrhythmia Clinic over the 1-year period (July 2016 through June 2017). Our primary outcome measure was change in decisional conflict between the first and second clinical visit. Decisional conflict decreased from an average of 31 to 9. Mean change was 22.3 (95% CI, 25.7 - 37.1), corresponding to an effect size of 0.94 standard deviations. Satisfaction with decision increased from 4.0 to 4.5, measures of therapeutic alliance with the care team (Kim Alliance scale) increased from 100.1 to 103.1, and satisfaction with pro...Continue Reading

Associated Clinical Trials

Citations

Feb 1, 2020·Stroke; a Journal of Cerebral Circulation·Robert J StantonDawn O Kleindorfer
Jul 24, 2020·JAMA Internal Medicine·Marleen KunnemanUNKNOWN Shared Decision Making for Atrial Fibrillation (SDM4AFib) Trial Investigators
Mar 28, 2020·MDM Policy & Practice·Adeboye A Adejare, Mark H Eckman
Sep 9, 2020·JAMA Internal Medicine·Marleen KunnemanUNKNOWN Shared Decision Making for Atrial Fibrillation (SDM4AFib) Trial Investigators
Apr 27, 2021·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Victor D Torres RoldanJuan P Brito
Jul 3, 2021·Global Heart·Ben FreedmanJanina Stepinska
Jan 14, 2022·Journal of the American Heart Association·Peter A NoseworthyUNKNOWN SDM4AFib (Shared Decision‐Making for Atrial Fibrillation) Trial Investigators *

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