A Comprehensive Approach to Decision Aids Supporting Shared Decision Making in Cardiac Rehabilitation

In recent years, patients' interest in taking control of their own health and rehabilitation has grown. Shared decision making (SDM) advocates for the involvement of patients in making preference-sensitive decisions about their health and care. Optimal support for patients' and healthcare professionals' participation in the SDM process builds on effective, comprehensive tools revealing available evidence and encouraging patient preference elicitation. Moreover, these tools can guide them through the SDM process and offer support during follow-up. Digital tools that facilitate SDM mainly focus on supporting patients when making major decisions. Educating patients about their options, while highlighting their associated benefits and risks, and fostering collaboration and discussion in the encounter are essential components in these tools. Nevertheless, it is important to give patients the support they need when making decisions with less impact at home and empower them to become active participants in their daily care. In the context of cardiac rehabilitation (CR), these levels of decision making are apparent. In this paper, we propose a framework of levels of decision making and a timeline for tools supporting shared decision making in CR. Furthermore, a categorization of SDM tools is presented. These contributions guide researchers aiming to empower patients, and keeping patients engaged and motivated throughout the CR program to make lifestyle changes.

[1]  A Gafni,et al.  Physician-patient-companion communication and decision-making: a systematic review of triadic medical consultations. , 2013, Patient education and counseling.

[2]  France Légaré,et al.  Decision aids for people facing health treatment or screening decisions. , 2017, The Cochrane database of systematic reviews.

[3]  A. Untas,et al.  Treatment decision-making in chronic diseases: What are the family members' roles, needs and attitudes? A systematic review. , 2017, Patient education and counseling.

[4]  M. Morris,et al.  Patients in context: recognizing the companion as part of a patient-centered team. , 2013, Patient education and counseling.

[5]  E. Hess,et al.  Implementation of Shared Decision Making in Cardiovascular Care: Past, Present, and Future , 2014, Circulation. Cardiovascular quality and outcomes.

[6]  Amiram Gafni,et al.  Should Clinicians Deliver Decision Aids? Further Exploration of the Statin Choice Randomized Trial Results , 2009, Medical decision making : an international journal of the Society for Medical Decision Making.

[7]  B. Franklin,et al.  Program participation, exercise adherence, cardiovascular outcomes, and program cost of traditional versus modified cardiac rehabilitation. , 2000, The American journal of cardiology.

[8]  M. Haug,et al.  Issues in Elderly Patient-Provider Interactions , 1987, Research on aging.

[9]  Silvia Gabrielli,et al.  Addressing challenges in promoting healthy lifestyles: the al-chatbot approach , 2017, PervasiveHealth.

[10]  Maarten J. IJzerman,et al.  A Systematic Review to Identify the Use of Preference Elicitation Methods in Healthcare Decision Making , 2014, Pharmaceutical Medicine.

[11]  D. Berwick.  A user's manual for the IOM's 'Quality Chasm' report. , 2002, Health affairs.

[12]  S. Jaglal,et al.  A qualitative systematic review of influences on attendance at cardiac rehabilitation programs after referral. , 2012, American heart journal.

[13]  A. Hasman,et al.  Effect of guideline based computerised decision support on decision making of multidisciplinary teams: cluster randomised trial in cardiac rehabilitation , 2009, BMJ : British Medical Journal.

[14]  Elliott S Fisher,et al.  Geography and the debate over Medicare reform. , 2002, Health affairs.

[15]  A. Beisecker,et al.  Aging and the desire for information and input in medical decisions: patient consumerism in medical encounters. , 1988, The Gerontologist.

[16]  J. Spertus,et al.  ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: a report by the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Th , 2009, Journal of the American College of Cardiology.

[17]  H. McGee,et al.  Cardiac rehabilitation in Europe: results from the European Cardiac Rehabilitation Inventory Survey , 2010, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[18]  Jennifer Elston Lafata,et al.  Where Is the Evidence? A Systematic Review of Shared Decision Making and Patient Outcomes , 2015, Medical decision making : an international journal of the Society for Medical Decision Making.

[19]  S. Ebrahim,et al.  Improving uptake and adherence in cardiac rehabilitation: literature review. , 2005, Journal of advanced nursing.

[20]  Stacey L. Sheridan,et al.  Heart to Heart: a computerized decision aid for assessment of coronary heart disease risk and the impact of risk-reduction interventions for primary prevention. , 2004, Preventive cardiology.

[21]  L. Siminerio,et al.  A Shared Decision-Making Approach to Telemedicine: Engaging Rural Patients in Glycemic Management , 2016, Journal of clinical medicine.

[22]  N. Pogosova,et al.  [Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery]. , 2014, Kardiologiia.

[23]  Mieke Haesen,et al.  A Grounded Approach for Applying Behavior Change Techniques in Mobile Cardiac Tele-Rehabilitation , 2016, PETRA.

[24]  G. Elwyn,et al.  Shared decision making: really putting patients at the centre of healthcare , 2012, BMJ : British Medical Journal.

[25]  Alexander A Kon,et al.  The shared decision-making continuum. , 2010, JAMA.

[26]  Trudy van der Weijden,et al.  Improving cardiovascular risk management: a randomized, controlled trial on the effect of a decision support tool for patients and physicians , 2007, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[27]  K. Coninx,et al.  Bridging Patients’ Needs and Caregivers’ Perspectives to Tailor Information Provisioning during Cardiac Rehabilitation , 2018 .

[28]  Joseph Burns,et al.  Patient Engagement: How Patient-provider Partnerships Transform Healthcare Organizations , 2012, Managed care.

[29]  Cornelia M. Ruland,et al.  Research Paper: Handheld Technology to Improve Patient Care: Evaluating a Support System for Preference-based Care Planning at the Bedside , 2002, J. Am. Medical Informatics Assoc..

[30]  Paul Dendale,et al.  Cardiac telerehabilitation: A novel cost-efficient care delivery strategy that can induce long-term health benefits , 2017, European journal of preventive cardiology.

[31]  Warner M Mampuya,et al.  Cardiac rehabilitation past, present and future: an overview. , 2012, Cardiovascular diagnosis and therapy.

[32]  A M Stiggelbout,et al.  Shared decision making: Concepts, evidence, and practice. , 2015, Patient education and counseling.

[33]  Sergey S. Tarima,et al.  Cardiac Rehabilitation Patient and Organizational Factors: What Keeps Patients in Programs? , 2013, Journal of the American Heart Association.

[34]  Dawn Stacey,et al.  Decision aids for people facing health treatment or screening decisions. , 2009, The Cochrane database of systematic reviews.

[35]  Karin Coninx,et al.  The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology , 2017, European journal of preventive cardiology.

[36]  D. Brooks,et al.  Adherence to a cardiac rehabilitation home program model of care: a comparison to a well-established traditional on-site supervised program. , 2012, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[37]  R. Adelman,et al.  The physician-elderly patient-companion triad in the medical encounter: the development of a conceptual framework and research agenda. , 1987, The Gerontologist.

[38]  S. Ebrahim,et al.  Provision, uptake and cost of cardiac rehabilitation programmes: improving services to under-represented groups. , 2004, Health technology assessment.

[39]  Li Liang,et al.  Predictors of cardiac rehabilitation referral in coronary artery disease patients: findings from the American Heart Association's Get With The Guidelines Program. , 2009, Journal of the American College of Cardiology.

[40]  Stacey L Sheridan,et al.  Shared decision making about screening and chemoprevention. a suggested approach from the U.S. Preventive Services Task Force. , 2004, American journal of preventive medicine.

[41]  Paul Dendale,et al.  Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery , 2014, European journal of preventive cardiology.

[42]  Jianwen Cai,et al.  A randomized trial of an intervention to improve use and adherence to effective coronary heart disease prevention strategies , 2011, BMC health services research.

[43]  G. Elwyn,et al.  Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. , 2014, Patient education and counseling.

[44]  Mario J. Garcia,et al.  ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization , 2009, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[45]  Harlan M. Krumholz,et al.  Decision Making in Advanced Heart Failure: A Scientific Statement From the American Heart Association , 2012, Circulation.

[46]  Heidemarie Keller,et al.  Absolute Cardiovascular Disease Risk and Shared Decision Making in Primary Care: A Randomized Controlled Trial , 2008, The Annals of Family Medicine.

[47]  R. Thomson,et al.  Decision aids for people facing health treatment or screening decisions. , 2003, The Cochrane database of systematic reviews.