Caution Regarding Government-Mandated Shared Decision Making for Patients with Atrial Fibrillation

Although cardiovascular clinicians are increasingly encouraged to incorporate a shared decision-making (SDM) approach with their patients with atrial fibrillation (AF) at risk for stroke, limited guidance is available on how to navigate this complex interaction. Referring physicians, who know their patients best, struggle to present risks and benefits of newer therapies, whereas subspecialists are challenged to rapidly learn new patients' values and preferences. Decision aids are consistently shown to improve patient outcomes, such as knowledge, engagement, and satisfaction,1 yet poor implementation of an SDM approach by clinicians across routine practice speaks to the ongoing need for a greater understanding of where in the care process SDM is best used and with what tools.