Impact of shared decision-making in Taiwanese patients with atrial fibrillation eligible for novel oral anticoagulant therapy.
Journal
Journal of the Formosan Medical Association
Series/Report No.
Journal of the Formosan Medical Association
ISSN
0929-6646
Date Issued
2024-09-07
Author(s)
Lin, Tsung-Hsien
Yang, Yuan-Po
Wu, Wei-Tsung
Tu, Chung-Ming
Huang, Hung-Kain
Chu, Chun-Yuan
Huang, Chi-Cheng
Chien, Szu-Chi
Jhuo, Shih-Jie
Chen, Ching-Pei
DOI
10.1016/j.jfma.2024.08.036
Abstract
Background/Purpose: Shared decision-making (SDM) promotes patient awareness about medical conditions and treatments, facilitating patient involvement in care decisions. This two-stage multicenter study evaluated impacts of SDM in Taiwanese adults with atrial fibrillation (AF) eligible for novel oral anticoagulant (NOAC) therapy. Methods: Participants were NOAC-naïve (part I) or dabigatran-experienced (part II). During Stage I, part I participants (n = 124) completed a semi-structured survey (understanding evaluation sections only) before and after viewing SDM materials on stroke prevention for AF. Surveys collected data on anxiety about AF, confidence in healthcare professionals, usefulness of the SDM materials, and perception of different NOACs. During Stage II, part I participants after being prescribed NOACs, and part II participants completed another survey to compare impacts of SDM. Results: During Stage I, dabigatran was the preferred NOAC after viewing the SDM materials among 90% of part I participants. During Stage II, both part I (n = 87) and part II participants (n = 104) completed another survey. Fewer part I participants were anxious about AF (p < 0.01), and more had confidence in healthcare professionals (p < 0.01) after viewing SDM materials than before. Most part I participants (≥90%) rated the SDM materials as “very helpful”. In Stage II, participants viewing SDM before initiating dabigatran had lower anxiety (part I, 43%; part II, 53%; p < 0.01) and a higher trust (part I, 92%; part II, 84%; p < 0.01). Conclusion: In conclusion, SDM reduced anxiety and improved trust in healthcare professionals among NOAC-naïve participants with AF.
Subjects
Anticoagulants
Atrial fibrillation
Decision making
Novel oral anti-coagulants
Shared
Taiwan
Publisher
Elsevier B.V.
Type
journal article