Shared Decision Making in Patients with Stable Coronary Artery Disease: PCI Choice

被引:43
作者
Coylewright, Megan [1 ,2 ]
Shepel, Kathy [3 ]
LeBlanc, Annie [2 ]
Pencille, Laurie [2 ]
Hess, Erik [2 ,4 ]
Shah, Nilay [2 ,5 ]
Montori, Victor M. [2 ,5 ,6 ]
Ting, Henry H. [1 ,2 ]
机构
[1] Mayo Clin, Dept Med, Div Cardiovasc Dis, Rochester, MN 55905 USA
[2] Mayo Clin, Knowledge & Evaluat Res Unit, Rochester, MN USA
[3] Mayo Clin, Sect Creat Media, Rochester, MN USA
[4] Mayo Clin, Dept Emergency Med, Div Emergency Med Res, Rochester, MN USA
[5] Mayo Clin, Dept Hlth Sci Res, Div Hlth Care Policy & Res, Rochester, MN USA
[6] Mayo Clin, Dept Med, Div Endocrinol Diabet Metab & Nutr, Rochester, MN USA
来源
PLOS ONE | 2012年 / 7卷 / 11期
关键词
TYPE-2; DIABETES-MELLITUS; PILOT RANDOMIZED-TRIAL; MEDICAL THERAPY; INFORMED-CONSENT; AD HOC; AID; OUTCOMES; INTERVENTION; OSTEOPOROSIS; ANGIOGRAPHY;
D O I
10.1371/journal.pone.0049827
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) are comparable, alternative therapies for many patients with stable angina; however, patients may have misconceptions regarding the impact of PCI on risk of death and myocardial infarction (MI) in stable coronary artery disease (CAD). Methods and Results: We designed and developed a patient-centered decision aid (PCI Choice) to promote shared decision making for patients with stable CAD. The estimated benefits and risks of PCI+OMT as compared to OMT were displayed in a decision aid using pictographs with natural frequencies and text. We engaged patients, clinicians, health service researchers, and designers with over 20 successive iterations of the decision aid, which were field tested during real-world clinical encounters involving clinicians and patients. The decision aid is intended to facilitate knowledge transfer, deliberation based on patient values and preferences, and shared decision making. Conclusions: We describe the methods and outcomes of the design and development of a decision aid (PCI Choice) to promote shared decision making between clinicians and patients regarding the choice of PCI+OMT vs. OMT for treatment of stable CAD. We will evaluate the impact of PCI Choice on patient knowledge, decisional conflict, participation in decision-making, and treatment choice in an upcoming randomized trial. Citation: Coylewright M, Shepel K, LeBlanc A, Pencille L, Hess E, et al. (2012) Shared Decision Making in Patients with Stable Coronary Artery Disease: PCI Choice. PLoS ONE 7(11): e49827. doi:10.1371/journal.pone.0049827
引用
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页数:8
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