Decision aids reduce DT-LVAD implantation in advanced heart failure
Shared decision support with the use of standardized decision aids improves decision quality and reduces implantation of left ventricular assist device as destination therapy (DT-LVAD) in patients with advanced heart failure. [Allen LA, AHA 2017, session LBS.06
In a real-world study in 248 patients considering DT-LVAD, researchers found improved decision quality in the intervention group (n=113) of patients who received education provided by healthcare staff along with a pamphlet (88 percent) or video (92 percent) decision aid.
Patients’ knowledge improved by 10.9 percent in the intervention group, compared with a 5.4 percent improvement in the control group (n=135) of patients who received usual care. Values-choice concordance was also higher in the intervention vs control group (correlation coefficient, 0.48 vs 0.17).
At 6 months, DT-LVAD implantation rate was 54 percent in the intervention group vs 80 percent in the control group – a significant 26 percent difference (p=0.008).
No significant differences were found between the groups in secondary outcomes such as decision regret, illness acceptance, stress, depression and quality of life.