%0 Journal Article
%T Evaluating the Effect of a Patient Decision Aid for Atrial Fibrillation Stroke Prevention Therapy
%A Alison McClean
%A Anita I. Kapanen
%A James Hicklin
%A Jason G. Andrade
%A Jenny MacGillivray
%A Larry D. Lynd
%A Leanne Kwan
%A Nick Bansback
%A Peter S. Loewen
%A Shahrzad Salmasi
%J Annals of Pharmacotherapy
%@ 1542-6270
%D 2019
%R 10.1177/1060028019828420
%X 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, usability/acceptability, patient preferences, effects on therapy choices, and participant feedback. Results: 37 participants completed the PDA. The PDA could be completed independently and was well accepted. It significantly decreased the mean decisional conflict score (P < 0.001) and all its subscales and increased participant AF knowledge (P = 0.02). 76% of participants indicated that their individualized therapy attribute ranking was congruent with their values. The PDA-generated best-match therapy was chosen by 70% of participants in decision 1 (no therapy, aspirin, or oral anticoagulant), and 17% for decision 2 (choice of anticoagulant). Among AF patients, 60% chose a different drug than that currently prescribed to them. Conclusion and Relevance: Our PDA was effective for reducing decisional conflict, increasing patient knowledge, eliciting patients¡¯ values, and presenting therapy options that aligned with patients¡¯ values and preferences. Using the PDA revealed that many patients have therapy preferences different from their currently prescribed treatment. The PDA is a practical and potentially valuable tool to facilitate decision making about stroke prevention therapy for AF
%K atrial fibrillation
%K anticoagulation
%K patient decision aid
%K shared decision making
%K bleeding
%K stroke prevention
%U https://journals.sagepub.com/doi/full/10.1177/1060028019828420