TY - JOUR
T1 - Shared Decision Making in Patients with Stable Coronary Artery Disease
T2 - PCI Choice
AU - Coylewright, Megan
AU - Shepel, Kathy
AU - LeBlanc, Annie
AU - Pencille, Laurie
AU - Hess, Erik
AU - Shah, Nilay
AU - Montori, Victor M.
AU - Ting, Henry H.
PY - 2012/11/30
Y1 - 2012/11/30
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84870612818&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84870612818&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0049827
DO - 10.1371/journal.pone.0049827
M3 - Article
C2 - 23226223
AN - SCOPUS:84870612818
SN - 1932-6203
VL - 7
JO - PloS one
JF - PloS one
IS - 11
M1 - e49827
ER -