Liana Fraenkel|Richard L. Street|Virginia Towle|John O’Leary|Lynne Iannone|Peter H. Van Ness|Terri R. Fried
A Pilot Randomized Controlled Trial of a Decision Support Tool to Improve the Quality of Communication and Decision-Making in Individuals with Atrial Fibrillation
Yale University|VA Connecticut Healthcare System|Texas A&M University|Baylor College of Medicine|Yale University|Yale University|Yale University|Yale University|Yale University|VA Connecticut Healthcare System
objectives design tool nonvalvular atrial fibrillation nvaf inform individuals individual stroke bleeding risks assist clarifying priorities promote communication design clustered randomized controlled trial setting primary care clinics participants individuals nvaf n 135 intervention completion tool regularly scheduled visit measurements primary outcomes included 100point informed values clarity subscales decisional conflict scale lower scores indicate individual informed greater clarity secondary outcomes included knowledge patientclinician communication change treatment results sixtynine individuals enrolled intervention group 66 control group visit intervention participants lower scores informed mean difference 119 95 confidence interval ci 211 27 values clarity subscales mean difference 146 95 ci 226 66 greater proportions intervention participants knew medications reducing stroke risk 61 vs 31 p lt 001 side effects 49 vs 37 p 07 stroke 71 vs 12 bleeding risk 69 vs 20 discussed frequently intervention control group p lt 001 five intervention participants expressed preference medication concordant current treatment plan change treatment plan either group conclusion tool effective improving perceived actual knowledge values clarity increasing physicianpatient communication change treatment