Influence of decision aids on patient preferences for anticoagulant therapy: a randomized trial
Reads0
Chats0
TLDR
The decision aid led to significant improvement in patients' knowledge regardless of the format or graphic representation of data, and Revealing the name of the treatment options led tosignificant shifts in declared treatment preferences.Abstract:
Background: Decision aids have been shown to be useful in selected situations to assist patients in making treatment decisions. Important features such as the format of decision aids and their graphic presentation of data on benefits and harms of treatment options have not been well studied. Methods: In a randomized trial with a 3 × 2 factorial design, we investigated the effects of decision aid format (decision board, decision booklet with audiotape, or interactive computer program) and graphic presentation of data (pie graph or pictogram) on patients9 comprehension and choices of 3 treatments for anticoagulation, identified initially as “treatment A” (warfarin), “treatment B” (acetylsalicylic acid) and “treatment C” (no treatment). Patients aged 65 years or older without known atrial fibrillation and not currently taking warfarin were included. The effect of blinding to the treatment name was tested in a before–after comparison. The primary outcome was change in comprehension score, as assessed by the Atrial Fibrillation Information Questionnaire. Secondary outcomes were treatment choice, level of satisfaction with the decision aid, and decisional conflict. Results: Of 102 eligible patients, 98 completed the study. Comprehension scores (maximum score 10) increased by an absolute mean of 3.1 ( p p Interpretation: The decision aid led to significant improvement in patients9 knowledge regardless of the format or graphic representation of data. Revealing the name of the treatment options led to significant shifts in declared treatment preferences.read more
Citations
More filters
Journal ArticleDOI
Decision aids for people facing health treatment or screening decisions
Dawn Stacey,Dawn Stacey,Krystina B. Lewis,Michael J. Barry,Carol Bennett,Karen Eden,Margaret Holmes-Rovner,Hilary A. Llewellyn-Thomas,Anne Lyddiatt,Richard Thomson,Lyndal Trevena +10 more
TL;DR: Decision aids reduced the proportion of undecided participants and appeared to have a positive effect on patient-clinician communication, and those exposed to a decision aid were either equally or more satisfied with their decision, the decision-making process, and the preparation for decision making compared to usual care.
Journal ArticleDOI
Bleeding risk assessment and management in atrial fibrillation patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis.
Gregory Y.H. Lip,Felicita Andreotti,Laurent Fauchier,Kurt Huber,Elaine M. Hylek,Eve Knight,Deirdre A. Lane,Marcel Levi,Francisco Marín,Gualtiero Palareti,Paulus Kirchhof +10 more
TL;DR: The main aim of the document was to summarise 'best practice' in dealing with bleeding risk in AF patients when approaching antithrombotic therapy, by addressing the epidemiology and size of the problem, and review established bleeding risk factors.
Journal ArticleDOI
Patient Values and Preferences in Decision Making for Antithrombotic Therapy: A Systematic Review: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
Samantha MacLean,Sohail M. Mulla,Elie A. Akl,Miłosz Jankowski,Per Olav Vandvik,Shanil Ebrahim,Shelley McLeod,Neera Bhatnagar,Gordon H. Guyatt +8 more
TL;DR: Patient values and preferences regarding thromboprophylaxis treatment appear to be highly variable and it should be standard for clinical practice guidelines to conduct systematic reviews of patient values and preference in the specific content area.
Journal ArticleDOI
Bleeding risk assessment and management in atrial fibrillation patients: a position document from the European Heart Rhythm Association, endorsed by the European Society of Cardiology Working Group on Thrombosis.
Gregory Y.H. Lip,Felicita Andreotti,Laurent Fauchier,Kurt Huber,Elaine M. Hylek,Eve Knight,Deirdre A. Lane,Marcel Levi,Francisco Marín,Gualtiero Palareti,Paulus Kirchhof,Jean-Philippe Collet,Andrea Rubboli,Daniela Poli,John Camm +14 more
TL;DR: This Position Document comprehensively review the published evidence and proposes a consensus on bleeding risk assessments in AF patients, with a view to summarizing 'best practice' when approaching antithrombotic therapy inAF patients.
Journal ArticleDOI
Educational intervention improves anticoagulation control in atrial fibrillation patients:the TREAT randomised trial
TL;DR: A theory-driven educational intervention significantly improves time within therapeutic range (TTR) in AF patients initiating warfarin during the first 6-months, and adverse clinical outcomes may potentially be reduced by improving patients’ understanding of the necessity ofwarfarin and reducing their perception of treatment harm.
References
More filters
Journal ArticleDOI
Prospective evaluation of an index for predicting the risk of major bleeding in outpatients treated with warfarin
TL;DR: The Outpatient Bleeding Risk Index prospectively classified patients according to risk of major bleeding and performed better than physicians and may be preventable in many high-risk patients by avoidance of over-anticoagulation and nonsteroidal anti-inflammatory agents.
Journal ArticleDOI
Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation
Robert G. Hart,Lesly A. Pearce +1 more
TL;DR: Adjusted-dose warfarin and aspirin reduce stroke in patients with atrial fibrillation, andWarfarin is substantially more efficacious than aspirin.
Journal ArticleDOI
Risk Factors for Complications of Chronic Anticoagulation: A Multicenter Study
Stephan D. Fihn,Mary B. McDonell,Donald C. Martin,Jorja G. Henikoff,Domokos Vermes,Daniel L. Kent,Richard H. White +6 more
TL;DR: The incidence of bleeding and thromboembolic complications and related risk factors from a retrospective study of 980 patients followed in five anticoagulation clinics through 1990 are described.
Journal ArticleDOI
The Risk for and Severity of Bleeding Complications in Elderly Patients Treated with Warfarin
Stephan D. Fihn,Catherine M. Callahan,Donald C. Martin,Mary B. McDonell,Jorja G. Henikoff,Richard H. White +5 more
TL;DR: This study analyzed data from six anticoagulation clinics to determine whether elderly patients who were receiving warfarin had a higher incidence of complications than similar younger patients who are also receiving warFarin.
Journal ArticleDOI
Antithrombotic therapy for atrial fibrillation
TL;DR: Anticoagulant therapy is still underprescribed in patients with atrial fibrillation, particularly in elderly patients, who stand to benefit most.