Heart Failure, Shared Decision-making, and Social Determinants of Health

Enard, Kimberly R.; Hauptman, Paul J.

doi:10.1001/jamacardio.2019.1763

Cited by 20 publications

(14 citation statements)

References 4 publications

(12 reference statements)

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“…In particular, we suggest that clinicians may be able to augment routine HF education with anticipatory guidance tailored toward the unique challenges encountered by homeless individuals. These recommendations echo recent calls for providers to engage in shared decision-making with patients incorporating SDOH such as housing, educational attainment, language barriers, and cultural norms (Enard & Hauptman, 2019).…”

mentioning

confidence: 80%

Centering the narrative experiences of homeless individuals: a call to action

Pendyal

2022

J Transcult Nurs

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mentioning

confidence: 80%

Centering the narrative experiences of homeless individuals: a call to action

Pendyal

2022

J Transcult Nurs

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“…Recent policy changes in the United States have provided a combination of "carrots and sticks, " that is, incentives and penalties for engaging patients. 145 We also need a shift in how health care is presented in the media and more role models for active engagement. Our media is replete with images of passive patients and hero clinicians, reinforcing stigmas and stereotypes.…”

Section: Health Policy Contextmentioning

confidence: 99%

Shared Decision-Making and Cardiovascular Health: A Scientific Statement From the American Heart Association

Himmelfarb¹,

Beckie²,

Allen³

et al. 2023

Circulation

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Shared decision-making is increasingly embraced in health care and recommended in cardiovascular guidelines. Patient involvement in health care decisions, patient-clinician communication, and models of patient-centered care are critical to improve health outcomes and to promote equity, but formal models and evaluation in cardiovascular care are nascent. Shared decision-making promotes equity by involving clinicians and patients, sharing the best available evidence, and recognizing the needs, values, and experiences of individuals and their families when faced with the task of making decisions. Broad endorsement of shared decision-making as a critical component of high-quality, value-based care has raised our awareness, although uptake in clinical practice remains suboptimal for a range of patient, clinician, and system issues. Strategies effective in promoting shared decision-making include educating clinicians on communication techniques, engaging multidisciplinary medical teams, incorporating trained decision coaches, and using tools (ie, patient decision aids) at appropriate literacy and numeracy levels to support patients in their cardiovascular decisions. This scientific statement shines a light on the limited but growing body of evidence of the impact of shared decision-making on cardiovascular outcomes and the potential of shared decision-making as a driver of health equity so that everyone has just opportunities. Multilevel solutions must align to address challenges in policies and reimbursement, system-level leadership and infrastructure, clinician training, access to decision aids, and patient engagement to fully support patients and clinicians to engage in the shared decision-making process and to drive equity and improvement in cardiovascular outcomes.

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“…[17] The abundance of available HFrEF pharmacotherapy options has resulted in a renewed call for novel strategies to facilitate SDM for HFrEF pharmacotherapy, including interactive decision aids that provide individualized estimates of benefits and harms. [18][19][20] Most recently, the 2021 American College of Cardiology Consensus Decision Pathway for Optimization of Heart Failure Treatment advocates for SDM and use of decision aids for HFrEF pharmacotherapy decisions when available. [7] To date, integration of SDM has been limited to decisions regarding device therapy and palliative care in patients with advanced HF.…”

Section: Introductionmentioning

confidence: 99%

Decisional Needs and Patient Treatment Preferences for Heart Failure Medications: Scoping Review Protocol

Turgeon

Barry

MacDonald

2022

Preprint

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Introduction: Treatment decisions regarding heart failure with reduced ejection fraction (HFrEF; ejection fraction <=40%) pharmacotherapy are complex. Decision aids can bridge this knowledge-to-practice gap and improve the integration of patient preferences and values for patient-centered care. However, little is known about the preferences and decisional needs of patients regarding these medications. The objectives of this scoping review are to identify, map and synthesize the literature evaluating the decisional needs, treatment preferences and values of patients making decisions regarding HFrEF medications. Methods and Analysis: We will search MEDLINE, Embase, CINAHL (inception-April 2022), bibliographies of included studies and relevant reviews, Web of Science Cited References, cocites.com, clinicaltrials.gov, Epistemonikos, and the Ottawa Decision Aid Inventory, without language restriction. We will include qualitative, quantitative, and mixed-methods studies that describe patient and clinician decisional needs, or patient treatment preferences or values regarding HFrEF medications guided by the Ottawa Decision Support Framework, or decision aids to support HFrEF medication decisions. One author will perform all searches and upload results to Covidence. Two review authors will independently screen retrieved article titles and abstracts for inclusion, review full-text for final inclusion, and extract data from included articles and decision aids using a standardized data extraction form. We will present a graphical abstract mapping what is known about decisional needs and patient preferences and values, decisional support interventions, and decisional outcomes regarding HFrEF medications. We will also describe extracted data in narrative and tabular format to address the scoping review objectives, and discuss implications for practice and subsequent research in the field of shared decision-making for HFrEF. Ethics and Dissemination: Research ethics board approval is not required for this scoping review of published data. We will present the findings at relevant conferences, publish a peer-reviewed manuscript, and disseminate results via institutional and partner social media platforms.

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Heart Failure, Shared Decision-making, and Social Determinants of Health

Cited by 20 publications

References 4 publications

Centering the narrative experiences of homeless individuals: a call to action

Centering the narrative experiences of homeless individuals: a call to action

Shared Decision-Making and Cardiovascular Health: A Scientific Statement From the American Heart Association

Decisional Needs and Patient Treatment Preferences for Heart Failure Medications: Scoping Review Protocol

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