TY - JOUR
T1 - Patient Decision Aids for Aortic Stenosis and Chronic Coronary Artery Disease
T2 - A Systematic Review and Meta-Analysis
AU - Harris, Emma
AU - Benham, Alex
AU - Stephenson, John
AU - Conway, Dwayne
AU - Chong, Aun-Yeong
AU - Curtis, Helen
AU - Astin, Felicity
N1 - Funding Information:
We would like to thank Professor Richard Thomson for his expert guidance and support in the development of this review. We send thanks to Ellie Price for conducting the initial search of clinical trial registers. We would also like to thank the authors who provided further details about their PtDA and research study. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. F.A., E.H., and D.C. received research funding in a competitive peer review process from Grow MedTech (POF000186 and POF000103) and the National Institute of Health and Care Research (NIHR204012) to develop and test a PCI PtDA called CONNECT, which is included in this review. A second author (A.B.), not involved in the development or testing of CONNECT, assessed its quality. A.-Y.C. receives honoraria and an unrestricted grant from Abbott. A.B., J.S., and H.C. have no conflicting interests.
Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2024/8/1
Y1 - 2024/8/1
N2 - Aims: Shared decision-making is recommended for patients considering treatment options for severe aortic stenosis (AS) and chronic coronary artery disease (CAD). This review aims to systematically identify and assess patient decision aids (PtDAs) for chronic CAD and AS and evaluate the international evidence on their effectiveness for improving the quality of decision-making. Methods and results: Five databases (Cochrane, CINAHL, Embase, MEDLINE, and PsycInfo), clinical trial registers, and 30 PtDA repositories/websites were searched from 2006 to March 2023. Screening, data extraction, and quality assessments were completed independently by multiple reviewers. Meta-analyses were conducted using Stata statistical software. Eleven AS and 10 CAD PtDAs were identified; seven were less than 5 years old. Over half of the PtDAs were web based and the remainder paper based. One AS and two CAD PtDAs fully/partially achieved international PtDA quality criteria. Ten studies were included in the review; four reported on the development/evaluation of AS PtDAs and six on CAD PtDAs. Most studies were conducted in the USA with White, well-educated, English-speaking participants. No studies fulfilled all quality criteria for reporting PtDA development and evaluation. Meta-analyses found that PtDAs significantly increased patient knowledge compared with 'usual care' (mean difference: 0.620; 95% confidence interval 0.396-0.845, P < 0.001) but did not change decisional conflict. Conclusion: Patients who use PtDAs when considering treatments for AS or chronic CAD are likely to be better informed than those who do not. Existing PtDAs may not meet the needs of people with low health literacy levels as they are rarely involved in their development.
AB - Aims: Shared decision-making is recommended for patients considering treatment options for severe aortic stenosis (AS) and chronic coronary artery disease (CAD). This review aims to systematically identify and assess patient decision aids (PtDAs) for chronic CAD and AS and evaluate the international evidence on their effectiveness for improving the quality of decision-making. Methods and results: Five databases (Cochrane, CINAHL, Embase, MEDLINE, and PsycInfo), clinical trial registers, and 30 PtDA repositories/websites were searched from 2006 to March 2023. Screening, data extraction, and quality assessments were completed independently by multiple reviewers. Meta-analyses were conducted using Stata statistical software. Eleven AS and 10 CAD PtDAs were identified; seven were less than 5 years old. Over half of the PtDAs were web based and the remainder paper based. One AS and two CAD PtDAs fully/partially achieved international PtDA quality criteria. Ten studies were included in the review; four reported on the development/evaluation of AS PtDAs and six on CAD PtDAs. Most studies were conducted in the USA with White, well-educated, English-speaking participants. No studies fulfilled all quality criteria for reporting PtDA development and evaluation. Meta-analyses found that PtDAs significantly increased patient knowledge compared with 'usual care' (mean difference: 0.620; 95% confidence interval 0.396-0.845, P < 0.001) but did not change decisional conflict. Conclusion: Patients who use PtDAs when considering treatments for AS or chronic CAD are likely to be better informed than those who do not. Existing PtDAs may not meet the needs of people with low health literacy levels as they are rarely involved in their development.
KW - Aortic Stenosis
KW - Chronic Coronary Artery Disease
KW - Patient decision aids
KW - Patient education
KW - Shared decision-making
KW - Aortic stenosis
KW - Coronary artery disease
UR - http://www.scopus.com/inward/record.url?scp=85203198517&partnerID=8YFLogxK
U2 - 10.1093/eurjcn/zvad138
DO - 10.1093/eurjcn/zvad138
M3 - Review article
VL - 23
SP - 561
EP - 581
JO - European Journal of Cardiovascular Nursing
JF - European Journal of Cardiovascular Nursing
SN - 1474-5151
IS - 6
ER -