Availability of patient decision aids for stroke prevention in atrial fibrillation: A systematic review

The objective of this review was to examine the existence and accessibility of, as well as select outcomes associated with, published, formally evaluated patient decision aids for stroke prevention in atrial fibrillation. Methods Six databases were searched from inception to March 2016 with a research librarian. Two authors independently reviewed potential articles, selected trials meeting inclusion criteria, and assessed outcome measures. Outcomes included: patient knowledge, involvement, choice, and decisional conflict. Results The search resulted in 666 articles; most were excluded for not examining stroke prevention in atrial fibrillation and seven studies were eventually included. Six decision aids displayed combinations of aspirin, warfarin, or no therapy; one included a DOAC. Interventions were associated with increased patient knowledge, increased likelihood of making a choice, and low decisional conflict. Use of decision aids in this review were associated with less selection of warfarin. None of the tested decision aids are currently available. Discussion Published patient decision aids for stroke prevention in atrial fibrillation are not accessible for clinical use. Given the availability of multiple comparable options, there is a need to develop and test new patient decision aids in this context.
Source: American Heart Journal - Category: Cardiology Source Type: research

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Abstract BACKGROUND: Stroke prevention therapy decisions for patients with atrial fibrillation (AF) are complex and require trade-offs, but few validated patient decision aids (PDAs) are available to facilitate shared decision making. OBJECTIVE: To evaluate the effects of a novel PDA on decision-making parameters for AF patients choosing stroke prevention therapy. METHODS: We developed an evidence-based individualized online AF PDA for stroke prevention therapy and evaluated it in a prospective observational pilot study. The primary outcome was decisional conflict. Secondary outcomes were knowledge, usab...
Source: The Annals of Pharmacotherapy - Category: Drugs & Pharmacology Authors: Tags: Ann Pharmacother Source Type: research
Smart belt for weight loss, spider-like walking car, terrifying Robo-Sharks, IoT cat toilet, the real version of the monolith from Space Odyssey: the world’s most famous tech circus brings the superlatives of innovation to Las Vegas every year. Here, we sorted out the most exciting, the less useful or the outright dumbest health technologies from CES 2019. The year of the solar cow What do power banks and cows have in common? The 2019 CES Innovation Award, actually. It’s a brilliant project of a South Korean solar energy company, Yolk, having partnered with a Kenyan educational institution, to keep children at...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Medicine ces CES 2019 digital digital health digital health tech gadgets health technology health trends Innovation smartwatch summit wearables Source Type: blogs
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
ConclusionsPooled analysis showed a significantly high prevalence of stroke (10%) inRS2200733 AF patients. AF patients with the studied SNPs had preserved left ventricular systolic function (i.e., ejection fraction greater than 50%). AF patients withRS10033464 presented larger left atrium diameter (44  mm (95% CI 42.02–45.98)) than those with other SNPs. The late AF recurrence rate was highest inRS2200733 patients (53% (95% CI 0.43 –0.64)). This study aids our understanding of the existing genetic findings and the function-altering “strongest” SNPs.
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
Purpose of review Atrial fibrillation is increasingly common in the ageing population. Patients with atrial fibrillation and HIV have a higher stroke risk, with guidelines recommending anticoagulation in the majority. Whilst anticoagulation options have diversified in the last decade for the general population, there is limited evidence for the safety and efficacy of these medications when used concurrently with antiretroviral therapy. We review the potential for patients with HIV on antiretroviral therapy to have direct-acting oral anticoagulations (DOACs). Recent findings Several case reports have been published in ...
Source: Current Opinion in HIV and AIDS - Category: Infectious Diseases Tags: CARDIOVASCULAR DISEASE IN HIV INFECTED PERSONS: Edited by Franck Boccara and Cameron J. Holloway Source Type: research
ConclusionsRisks could be communicated using decision aids with only one graphic. Showing the risk of stroke at 5 years could increase the prescription of OACs to patients with AF. Faced with the same risk of stroke, physicians prescribed less to themselves than to patients.
Source: European Journal of Clinical Investigation - Category: General Medicine Authors: Tags: Original Article Source Type: research
ConclusionsRisks could be communicated using decision aids with only one graphic. Showing the risk of stroke at 5 years could increase the prescription of OACs to patients with AF. Faced with the same risk of stroke, physicians prescribed less to themselves than to patients.This article is protected by copyright. All rights reserved.
Source: European Journal of Clinical Investigation - Category: General Medicine Authors: Tags: Original Paper Source Type: research
CONCLUSIONS: This review demonstrates that there is insufficient evidence to draw definitive conclusions regarding the impact of educational or behavioural interventions on TTR in AF patients receiving OAT. Thus, more trials are needed to examine the impact of interventions on anticoagulation control in AF patients and the mechanisms by which they are successful. It is also important to explore the psychological implications for patients suffering from this long-term chronic condition. PMID: 28378924 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
A 49-year-old male asthmatic (on Montelukast) with multiple sclerosis presented with shortness of breath and generalised weakness. On examination, he was in cardiac failure with a systolic murmur, rapid atrial fibrillation and weakness in all four limbs with slurred speech. His white cell count was 37x109/L, eosinophils 25x109/L, urea 13.6 mmol/L, creatinine 131 μmol/L, troponin I 4448 ng/L, anti-neutrophil cytoplasmic antibodies (ANCA) weakly positive (negative myeloperoxidase (MPO) and proteinase 3 (PR3)). Differential diagnoses included stroke, myocarditis and eosinophilic granulomatosis with polyangii...
Source: Heart Asia - Category: Cardiology Authors: Tags: Images in cardiovascular medicine Source Type: research
CONCLUSION: Our DA to allow patients to make an informed decision with their physician regarding dabigatran versus warfarin in AF, proved understandable, comprehensive and helpful. PMID: 24163147 [PubMed - indexed for MEDLINE]
Source: Journal of Population Therapeutics and Clinical Pharmacology - Category: Drugs & Pharmacology Tags: J Popul Ther Clin Pharmacol Source Type: research
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