PCI Choice: Cardiovascular clinicians' perceptions of shared decision making in stable coronary artery disease. Issue 6 (June 2017)

• Record Type: Journal Article
• Authors: Coylewright, Megan; O'Neill, Elizabeth S.; Dick, Sara; Grande, Stuart W.
• Is Part Of: Patient education and counseling. Volume 100:Issue 6(2017)
• Page Start: 1136
• Page End: 1143
• Publication Date: 2017-06
• Subjects: Decision aid -- Shared decision making -- Patient preference -- Stable angina -- Stable coronary artery disease -- Percutaneous coronary intervention; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2017.01.010
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Many clinicians have minimal knowledge of shared decision making. Clinicians are initially uncomfortable modifying baseline practice patterns. With use of a decision aid, clinicians identify knowledge gaps in shared decision making. Clinicians express interest in decision aids after multiple uses. Abstract: Objective: Describe cardiovascular clinicians' perceptions of Shared Decision Making following use of a decision aid (DA) for stable coronary artery disease (CAD) "PCI Choice", in a randomized controlled trial. Methods: We conducted a semi-structured qualitative interview study with cardiologists and physician extenders (n = 13) after using PCI Choice in practice. Interviews were transcribed then coded. Codes were organized into salient themes. Final themes were determined by consensus with all authors. Results: Most clinicians (70%) had no prior knowledge of SDM or DAs. Mixed views about the role of the DA in the visit were related to misconceptions of how patient education differed from SDM. Qualitative assessment of clinician perceptions generated three themes: 1) Gaps exist in clinician knowledge around SDM; 2) Clinicians are often uncomfortable with modifying baseline practice; and 3) Clinicians express interest in using DAs after initial exposure within a research setting. Conclusions: Use of DAs by clinicians during clinic visits may improve understanding of SDM. Initial use is marked by a reluctance to modify established practice patterns. Practice implications: As clinicians explore new approaches to benefit their patients, there is an opportunity for DAs that provide clinician instruction on core elements of SDM to lead to enhanced SDM in clinical practice.