Clinical Application and Efficiency Analysis of Shared Decision Making (SDM) in the Treatment of Stable Angina

Cheng, Hao‐Min; Hsu, Hsiao-Fen; Lee, Chih-Yi; Chang, Hong Di; Huang, Hsin-Chan; Sheu, Mei-Jyh; Chiu, Hsiao-Hui

doi:10.20849/ijsn.v5i2.751

Cited by 2 publications

(2 citation statements)

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“…Shared decision-making (SDM) is a person-centered approach in which collaborative discussions allow for patients to articulate values and preferences, and for clinicians to provide information based on patient wishes (Elwyn et al, 2012). This highly individualized approach to health care has been used in the context of care for a range of medical and mental health conditions or concerns including specialty areas of medicine (e.g., Beaver et al, 2005; Cheng et al, 2020), depression (Raue et al, 2010), and serious mental illness (Mahone, 2008; Zisman-Ilani et al, 2021). Research on SDM indicates that it is a model that may enhance engagement with treatment across a number of conditions, providing benefit to both patients and providers (Chen et al, 2021; Etingen et al, 2022; Trusty et al, 2019).…”

Section: Objectivementioning

confidence: 99%

Improving engagement and retention to treatment within VHA PTSD specialty care: Evolution of an outpatient program design.

Hessinger¹,

Etingen²,

Larsen³

et al. 2023

Psychological Services

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The Veteran's Health Administration (VA) and Department of Defense (DoD) posttraumatic stress disorder (PTSD) clinical practice guidelines (2017) recommend individual, trauma-focused therapy as the gold standard of treatment for PTSD (i.e., evidence-based practices [EBP]). Moreover, these guidelines encourage the use of individual shared decision-making (SDM) to increase engagement and completion of EBPs for PTSD in line with current literature. This study retrospectively evaluated three models of program design of a VA PTSD specialty clinic over the past 8 years. In line with previous literature, the study hypothesized that leveraging individualized SDM in the clinic design would lead to increased completion of EBPs for PTSD. Analyses indicated an impact as the models shifted from a group-based model to an individualized model. Specifically, as compared to veterans who completed a group-based design, a greater proportion of those enrolled in the clinic were more likely to complete an EBP. These results may suggest that individualized, patient-centered treatment planning may be related to patient engagement in EBPs for PTSD in contrast with group-based models. Other programmatic changes, such as changes in treatment options presented to patients, a movement to focus on EBPs for PTSD, and expanded clinic hours and telehealth options, possibly impacted veteran engagement and completion in EBPs. The study highlights the potential impacts of a changing patient population within the clinic over a relatively short period. The observations are discussed, and limitations are highlighted. The study shares the hope for additional randomized prospective studies of program designs. Impact StatementThis study examines the evolution of an outpatient VA PTSD clinical team as practices moved from group-based model to a more individualized, veteran-centric model. This study underscores the positive impact of a programmatic shift toward individualized care that occurred in concurrence with additional demographic shifts in the veteran clinical population, and availability of remote care options delivered via telehealth. Further clinical research is needed.

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Section: Objectivementioning

confidence: 99%

Improving engagement and retention to treatment within VHA PTSD specialty care: Evolution of an outpatient program design.

Hessinger¹,

Etingen²,

Larsen³

et al. 2023

Psychological Services

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“…Cardiac catheterization is an invasive treatment with the risks of side effects; education can be used to assist patients in evaluating and selecting proper methods of treatment. The biggest obstacle for medical personnel to implement SDM is the time it takes (Cheng, Hsu, Lee, Chang, Huang, Sheu, & Chiu, 2020). Therefore, comparing the differences between the effects of routine education methods and PDAs can be used as a reference for policies of promoting health education models in the future.…”

Section: Significance Of the Studymentioning

confidence: 99%

A Comparison of the Effectiveness of Share Decision Making and Standard Education for Cardiac Catheterization: A Pilot Study

Chiu

Cheng²,

Wang³

et al. 2021

IJSN

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Background: Cardiovascular diseases are the second leading cause of death in the top ten leading causes of death in 2018 in Taiwan, and coronary artery disease is one of the main causes.Aim: To compare whether there are differences in patient knowledge, anxiety, and satisfaction between the utilization of patient decision aid for cardiac catheterization and routine health education.Subject and methods: Between July 2020 and September 2020, subjects were recruited in the clinics of the Department of Cardiology in a Veterans hospital in northern Taiwan. An experimental design was used for the study. Subjects were divided into two different education tool groups by randomization table. Subjects filled out the questionnaires before and after the education.Result: The patient knowledge before and after education in the RC group was improved by 2.30 points, and SDM group increased by 1.50 points (p-value<0.05). The score of anxiety decreased by 0.41 points in the RC group after the education, and the score of anxiety decreased by 0.33 points in the SDM group. The levels of satisfaction of the SDM group were all higher than the RC group, but the satisfaction score for the duration of education in both groups was relatively low.Conclusion: Regardless of the standard or SDM education model, the knowledge level of patients can be improved, and there was a statistically significant difference (P<0.05). The anxiety of patients in both groups was reduced. The satisfactions of education in the SDM group were better than those of the RC group. The duration of education was the item with low satisfaction for both groups.Recommendations: Both methods of education can help patients increase their knowledge. The establishment of manpower responsible for education. Allowing patients to receive education before the examination can decrease anxiety and has clinical benefits.

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Clinical Application and Efficiency Analysis of Shared Decision Making (SDM) in the Treatment of Stable Angina

Cited by 2 publications

References 0 publications

Improving engagement and retention to treatment within VHA PTSD specialty care: Evolution of an outpatient program design.

Improving engagement and retention to treatment within VHA PTSD specialty care: Evolution of an outpatient program design.

A Comparison of the Effectiveness of Share Decision Making and Standard Education for Cardiac Catheterization: A Pilot Study

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