Shared Decision-Making and Patient Decision Aids

Sepucha, Karen

doi:10.1161/circoutcomes.112.966192

Cited by 9 publications

(2 citation statements)

References 10 publications

(9 reference statements)

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“…Educational initiatives should target a broad array of physician groups involved in the management of AF patients. To maximize the yield of patient-provider interactions, the development of decision aids for shared decision-making, 47 multifaceted educational materials, and point-of-care decision support is needed. Although it is logical to focus on educating cardiologists, education of primary care physicians, hospitalists, emergency physicians, and advanced practice providers will be essential to guide improved care.…”

Section: Recommendationsmentioning

confidence: 99%

Addressing barriers to optimal oral anticoagulation use and persistence among patients with atrial fibrillation: Proceedings, Washington, DC, December 3-4, 2012

Hess

Mirro

Diener

et al. 2014

American Heart Journal

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Approximately half of patients with atrial fibrillation (AF) and with risk factors for stroke are not treated with oral anticoagulation (OAC), whether it be with vitamin K antagonists (VKAs) or novel OACs (NOACs); and of those treated, many discontinue treatment. Leaders from academia, government, industry, and professional societies convened in Washington, DC, on December 3–4, 2012, to identify barriers to optimal OAC use and adherence and to generate potential solutions. Participants identified a broad range of barriers, including knowledge gaps about stroke risk and the relative risks and benefits of anticoagulant therapies; lack of awareness regarding the potential use of NOAC agents for VKA-unsuitable patients; lack of recognition of expanded eligibility for OAC; lack of availability of reversal agents and the difficulty of anticoagulant effect monitoring for the NOACs; concerns with the bleeding risk of anticoagulant therapy, especially with the NOACs and particularly in the setting of dual antiplatelet therapy; suboptimal time in therapeutic range for VKA; and costs and insurance coverage. Proposed solutions were to increase awareness of stroke risk as well as the benefits and risks of OAC use via educational initiatives and feedback mechanisms, to develop and disseminate shared decision-making tools, to better define the role of VKA in the current therapeutic era including eligibility and ineligibility for different anticoagulant therapies, to identify NOAC reversal agents and monitoring strategies and make knowledge regarding their use publicly available, to minimize the duration of dual antiplatelet therapy and concomitant OAC where possible, to improve time in therapeutic range for VKA, to leverage observational datasets to refine understanding of OAC use and outcomes in general practice, and to better align health system incentives.

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Section: Recommendationsmentioning

confidence: 99%

Addressing barriers to optimal oral anticoagulation use and persistence among patients with atrial fibrillation: Proceedings, Washington, DC, December 3-4, 2012

Hess

Mirro

Diener

et al. 2014

American Heart Journal

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“…We created a scoring system using a subset of questions adapted from previous research (Sepucha, 2010; Sepucha et al, 2008). We used six knowledge questions that prostate cancer experts deem critical for patients to understand before the patients make treatment decisions.…”

Section: Methodsmentioning

confidence: 99%

Association of quantitative information and patient knowledge about prostate cancer outcomes.

Fridman¹,

Ubel²,

Kahn³

et al. 2022

Health Psychology

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Objective: When the volume or complexity of health information exceeds the capacity to process it, patients may misinterpret or ignore critical information. Numerical information is especially challenging to process for many patients, yet no empirical data shows whether numerical information influences how well they could process and recall it. Method: Using natural language processing tools, we estimated the amount of numerical and probability-related (quantitative) information that was provided in 112 paired urology-radiology clinical consultations with patients who had been recently diagnosed with prostate cancer. The primary outcome measured was patient knowledge about their prostate cancer outcomes assessed before and after the consultations. Results: Patients with prostate cancer, Gleason score 6 or 7, and stage Time 1 or Time 2 participated in the study. Paired consultations included on average 11,086 words spoken. The relationship between quantitative information provided in consultations and patient knowledge about their cancer outcomes followed an inverted U-shape. There was a positive association between quantitative information and patient knowledge about their cancer outcomes. However, after the amount of quantitative information exceeded 4% (422 quantitative words) in paired consultations, the relationships between knowledge and the number of quantitative words became negative. Individual differences in education were not associated with observed relationships. Conclusion: Despite concerns about patients' capacity to process quantitative information, we found that patients' knowledge about cancer risks is positively associated with a certain amount of quantitative information. In the consultations, patients need to receive quantitative information that is well balanced with qualitative explanations.

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A Decision-Making Framework for Objective Risk Assessment in Older Adults with Severe Symptomatic Aortic Stenosis

et al. 2015

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Shared Decision-Making and Patient Decision Aids

Cited by 9 publications

References 10 publications

Addressing barriers to optimal oral anticoagulation use and persistence among patients with atrial fibrillation: Proceedings, Washington, DC, December 3-4, 2012

Addressing barriers to optimal oral anticoagulation use and persistence among patients with atrial fibrillation: Proceedings, Washington, DC, December 3-4, 2012

Association of quantitative information and patient knowledge about prostate cancer outcomes.

A Decision-Making Framework for Objective Risk Assessment in Older Adults with Severe Symptomatic Aortic Stenosis

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