The ARRIBA-Herz decision aid significantly improved patient participation and satisfaction compared to control (mean difference -0.80) and reduced decisional regret at 6 months.
RCT (n=1,132)
Single-blind
Cluster randomized
Sí
Does a simple decision aid for calculating absolute CVD risk and promoting shared decision making improve patient satisfaction and participation in primary care?
A primary care decision aid for absolute CVD risk communication significantly improved patient satisfaction, participation, and decisional regret without negatively impacting global CVD risk.
Estimación del efecto: Mean difference -0.80 (95% CI -1.23 to -0.37)
Tasa de eventos absoluta: 6.76% vs 7.56%
valor p: p=<.001
PURPOSE: We wanted to determine the effect of promoting the effective communication of absolute cardiovascular disease (CVD) risk and shared decision making through disseminating a simple decision aid for use in family practice consultations. METHODS: The study was based on a pragmatic, cluster randomized controlled trial (phase III) with continuing medical education (CME) groups of family physicians as the unit of randomization. In the intervention arm, 44 physicians (7 CME groups) consecutively recruited 550 patients in whom cholesterol levels were measured. Forty-seven physicians in the control arm (7 CME groups) similarly included 582 patients. Four hundred sixty patients (83.6%) of the intervention arm and 466 patients (80.1%) of the control arm were seen at follow-up. Physicians attended 2 interactive CME sessions and received a booklet, a paper-based risk calculator, and individual summary sheets for each patient. Control physicians attended 1 CME-session on an alternative topic. Main outcome measures were patient satisfaction and participation after the index consultation, change in CVD risk status, and decisional regret at 6 months' follow-up. RESULTS: Intervention patients were significantly more satisfied with process and result (Patient Participation Scale, difference 0.80, P<.001). Decisional regret was significantly lower at follow-up (difference 3.39, P = .02). CVD risk decreased in both groups without a significant difference between study arms. CONCLUSION: A simple transactional decision aid based on calculating absolute individual CVD risk and promoting shared decision making in CVD prevention can be disseminated through CME groups and may lead to higher patient satisfaction and involvement and less decisional regret, without negatively affecting global CVD risk.
Krones et al. (Thu,) conducted a rct in Cardiovascular disease risk (n=1,132). ARRIBA-Herz decision aid vs. Alternative CME topic (control) was evaluated on Patient participation and satisfaction (Patient Participation Scale) (Mean difference -0.80, 95% CI -1.23 to -0.37, p=<.001). The ARRIBA-Herz decision aid significantly improved patient participation and satisfaction compared to control (mean difference -0.80) and reduced decisional regret at 6 months.