TY - JOUR
T1 - The design and development of an encounter tool to support shared decision making about preventing cardiovascular events
AU - Hartasanchez, Sandra A.
AU - Hargraves, Ian G.
AU - Clark, Jennifer E.
AU - Gravholt, Derek
AU - Brito, Juan P.
AU - Branda, Megan E.
AU - Gomez, Yvonne L.
AU - Nautiyal, Vivek
AU - Khurana, Charanjit S.
AU - Thomas, Randal J.
AU - Montori, Victor M.
AU - Ridgeway, Jennifer L.
N1 - Publisher Copyright:
© 2022 Mayo Foundation for Medical Education and Research
PY - 2022/12
Y1 - 2022/12
N2 - Patients at high risk for cardiovascular disease (CVD) tend to receive less intensive preventive care. Clinical practice guidelines recommend shared decision making (SDM) to improve the quality of primary CVD prevention. There are tools for use during the clinical encounter that promote SDM, but, to our knowledge, there are no SDM encounter tools that support conversations about available lifestyle and pharmacological options that can lead to preventive care that is congruent with patient goals and CVD risk. Using the best available evidence and human-centered design (iterative design in the context of ultimate use with users), our team developed a SDM encounter tool, CV Prevention Choice. Each subsequent version during the iterative development process was evaluated in terms of content, usefulness, and usability by testing it in real preventive encounters. The final version of the tool includes a calculator that estimates the patient's risk of a major atherosclerotic CVD event in the next 10 years. Lifestyle and medication options are presented, alongside their pros, cons, costs, and other burdens. The risk reduction achieved by the selected prevention program is then displayed to support collaborative deliberation and decision making. A U.S. multicenter trial is estimating the effectiveness of CV Prevention Choice in achieving risk-concordant CV prevention while identifying the best strategies for increasing the adoption of the SDM encounter tool and its routine use in practice.
AB - Patients at high risk for cardiovascular disease (CVD) tend to receive less intensive preventive care. Clinical practice guidelines recommend shared decision making (SDM) to improve the quality of primary CVD prevention. There are tools for use during the clinical encounter that promote SDM, but, to our knowledge, there are no SDM encounter tools that support conversations about available lifestyle and pharmacological options that can lead to preventive care that is congruent with patient goals and CVD risk. Using the best available evidence and human-centered design (iterative design in the context of ultimate use with users), our team developed a SDM encounter tool, CV Prevention Choice. Each subsequent version during the iterative development process was evaluated in terms of content, usefulness, and usability by testing it in real preventive encounters. The final version of the tool includes a calculator that estimates the patient's risk of a major atherosclerotic CVD event in the next 10 years. Lifestyle and medication options are presented, alongside their pros, cons, costs, and other burdens. The risk reduction achieved by the selected prevention program is then displayed to support collaborative deliberation and decision making. A U.S. multicenter trial is estimating the effectiveness of CV Prevention Choice in achieving risk-concordant CV prevention while identifying the best strategies for increasing the adoption of the SDM encounter tool and its routine use in practice.
KW - Cardiovascular disease prevention
KW - Decision aids
KW - Encounter tools
KW - Shared decision making
UR - http://www.scopus.com/inward/record.url?scp=85139012449&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85139012449&partnerID=8YFLogxK
U2 - 10.1016/j.pmedr.2022.101994
DO - 10.1016/j.pmedr.2022.101994
M3 - Article
AN - SCOPUS:85139012449
SN - 2211-3355
VL - 30
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
M1 - 101994
ER -