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