“Replace uncertainty with information”: Shared decision-making and decision quality surrounding catheter ablation for atrial fibrillation

• DOI: 10.22541/au.170671010.06341848/v1
• Publication Date: 2024-01-31T14:08:36Z
• Authors: Meghan Reading Tu...; Sabrina Mangal; Jessica Ancker S; Jaslynn Gwyn; Paul Varosy; David Slotwiner
• Keywords: Decision quality; Decision aids; Patient Participation

Introduction: Shared decision-making (SDM) can support patients with atrial fibrillation (AF) to evaluate treatment options for rhythm and symptom control, but studies suggest it is not occurring meaningfully in routine practice. The objective of this study was measure decision quality describe processes among clinicians involved around catheter ablation AF. Methods: We conducted a cross-sectional, mixed-methods guided by SDM model outlining antecedents, processes, outcomes. Patients completed semi-structured interviews about ablation, feelings conflict regret, preferences the content, delivery, format hypothetical aid ablation. also surveys demographic characteristics literacy levels, AF symptoms using University Toronto Severity Scale (AFSS), aspects Controls-Preferences, Decisional Conflict, Decision Regret scales. Surveys were analyzed descriptive statistics qualitative data directed content analysis. Results: Fifteen (mean age 71.1 ± 8.6 years; 27% female; mean 7.0 [SD 7.0] months since ablation) five (three physicians, one NP, PA) recruited. Most preferred either share or relinquish control medical clinicians. For most patients, decisional regret low, cardiac health generally improved after However, they reported low levels information agency process. report routinely providing encouraging engagement during consultations. an interactive, web-based that clearly presents evidence regarding outcomes data, visualizations, videos, personalized risk assessments, available multiple languages. Conclusions: Disconnects between clinician efforts provide bolster patient experiences aids may be needed improve Reported current practices format, delivery user-centered design development aid.