Journal
JOURNAL OF CARDIOVASCULAR NURSING
Volume 36, Issue 2, Pages 143-150Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JCN.0000000000000694
Keywords
Decision support techniques; decision making; defibrillators; implantable; patient preference
Categories
Funding
- Canadian Council of Cardiovascular Nurses Research Grant
- Canadian Institutes of Health Research fellowship
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This study evaluated the feasibility of a decision support intervention for patients facing ICD replacement decisions. Results showed that the intervention was used as intended with high knowledge improvement, despite slow recruitment, indicating potential to enhance decision quality for ICD replacement.
Background Decision support can help patients facing implantable cardioverter-defibrillator (ICD) replacement understand their options and reach an informed decision reflective of their preferences. Objective The aim of this study was to evaluate the feasibility of a decision support intervention for patients faced with the decision to replace their ICD. Methods A pilot feasibility randomized trial was conducted. Patients approaching ICD battery depletion were randomized to decision support intervention or usual care. Feasibility outcomes included recruitment rates, intervention use, and completeness of data; secondary outcomes were knowledge, values-choice concordance, decisional conflict, involvement in decision making, and choice. Results A total of 30 patients were randomized to intervention (n = 15) or usual care (n = 15). The intervention was used as intended, with 2% missing data. Patients in the intervention arm had better knowledge (77.4% vs 51.1%; P = .002). By 12 months, 8 of 13 (61.5%) in the intervention arm and 10 of 14 (71.4%) in the usual care arm accepted ICD replacement; 1 per arm declined (7.7% vs 7.1%, respectively). Conclusion It was feasible to deliver the intervention, collect data, despite slow recruitment. The decision support intervention has the potential to improve ICD replacement decision quality.
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