Key result
Patients making decisions about complex cardiac device implantation often lack adequate knowledge and understanding, with decision-making styles varying between passive reliance on physician recommendation and active information seeking.
Why the study?
How do adult patients make decisions regarding first-time implantation of complex cardiac rhythm management devices?
How do adult patients make decisions regarding first-time implantation of complex cardiac rhythm management devices?
There is a need for further research to support the development of targeted decision support mechanisms for patients considering complex cardiac device implantation.
Answers are grounded in this paper and cite their sources.
Informs patient-centered device counseling; extends synthesis to guide targeted decision support development.
BACKGROUND: Complex cardiac rhythm management device (CRMD) therapy provides an important treatment option for people at risk of sudden cardiac death. Despite the survival benefit, device implantation is associated with significant physical and psychosocial concerns presenting considerable challenges for the decision-making process surrounding CRMD implantation for patients and physicians. AIMS: The purpose of this scoping review was to explore what is known about how adult (>16 years) patients make decisions regarding implantation of CRMD therapy. METHODS: Published, peer reviewed, English language studies from 2000 to 2016 were identified in a search across eight healthcare databases. Eligible studies were concerned with patient decision-making for first time device implantation. Quality assessment was completed using the mixed methods appraisal tool for all studies meeting the inclusion criteria. RESULTS: The findings of eight qualitative and seven quantitative studies, including patients who accepted or declined primary or secondary sudden cardiac death prevention devices, were clustered into two themes: knowledge acquisition and the process of decision-making, exposing similarities and distinctions with the treatment decision-making literature. CONCLUSION: The review revealed some insight in to the way patients approach decision-making but also exposed a lack of clarity and research activity specific to CRMD patients. Further research is recommended to support the development and application of targeted decision support mechanisms.
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Malecki-Ketchell et al. (2017) conducted a review in Decision-making for complex cardiac rhythm management device (CRMD) implantation. Decision-making regarding complex cardiac rhythm management device (CRMD) implantation was evaluated on Patient knowledge acquisition and the process of decision-making. Patients making decisions about complex cardiac device implantation often lack adequate knowledge and understanding, with decision-making styles varying between passive reliance on physician recommendation and active information seeking.
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