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Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation

BACKGROUND: Treatment with oral anticoagulants (OACs) could prevent stroke in atrial fibrillation (AF), but side effects developed due to OACs may cause patients anxiety during decision making. This study aimed to investigate whether shared decision making (SDM) reduces anxiety and improves adherenc...

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Autores principales: Chiu, Hsiao-Hui, Chang, Shih-Lin, Cheng, Hao-Min, Chao, Tze-Fan, Lin, Yenn-Jiang, Lo, Li-Wei, Hu, Yu-Feng, Chung, Fa-Po, Liao, Jo-Nan, Tuan, Ta-Chuan, Lin, Chin-Yu, Chang, Ting-Yung, Kuo, Ling, Liu, Chih-Min, Tsai, Yung-Nan, Huang, Yu-Ting, Chang, Yuh-Lih, Wung, Ju-Chieh, Chen, Shih-Ann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463811/
https://www.ncbi.nlm.nih.gov/pubmed/37608374
http://dx.doi.org/10.1186/s12911-023-02260-x
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author Chiu, Hsiao-Hui
Chang, Shih-Lin
Cheng, Hao-Min
Chao, Tze-Fan
Lin, Yenn-Jiang
Lo, Li-Wei
Hu, Yu-Feng
Chung, Fa-Po
Liao, Jo-Nan
Tuan, Ta-Chuan
Lin, Chin-Yu
Chang, Ting-Yung
Kuo, Ling
Liu, Chih-Min
Tsai, Yung-Nan
Huang, Yu-Ting
Chang, Yuh-Lih
Wung, Ju-Chieh
Chen, Shih-Ann
author_facet Chiu, Hsiao-Hui
Chang, Shih-Lin
Cheng, Hao-Min
Chao, Tze-Fan
Lin, Yenn-Jiang
Lo, Li-Wei
Hu, Yu-Feng
Chung, Fa-Po
Liao, Jo-Nan
Tuan, Ta-Chuan
Lin, Chin-Yu
Chang, Ting-Yung
Kuo, Ling
Liu, Chih-Min
Tsai, Yung-Nan
Huang, Yu-Ting
Chang, Yuh-Lih
Wung, Ju-Chieh
Chen, Shih-Ann
author_sort Chiu, Hsiao-Hui
collection PubMed
description BACKGROUND: Treatment with oral anticoagulants (OACs) could prevent stroke in atrial fibrillation (AF), but side effects developed due to OACs may cause patients anxiety during decision making. This study aimed to investigate whether shared decision making (SDM) reduces anxiety and improves adherence to stroke prevention measures in patients with AF. METHODS: A one-group pretest–posttest design using a questionnaire survey was applied at the outpatient cardiology clinic between July 2019 until September 2020. A Patient Decision Aid (PDA) tool was used for the completion of the questionnaire survey after health education and counseling. Ten questions were included for patients’ recognition of SDM, and a 5-point scoring method was used, where “very much” was scored as 5 points, and “totally not” was scored as 1 point. RESULTS: Fifty-two patients with AF were enrolled. In terms of patients’ recognition of SDM, points of more than 4.17 out of 5 were noted, indicating recognition above the level of “very much.” The patients’ anxiety scores before SDM were 3.56 (1.2), with a decrease of 0.64 points (p < 0.001) to 2.92 (1.3) after SDM. After SDM, the number of patients who decided to take OAC increased from 76.9% to 88.5%, and the 15.4% answering “unclear” decreased to 1.9% (p = 0.006). The patients’ anxiety levels after SDM were associated with gender (p = 0.025). CONCLUSIONS: The approach using SDM enhanced our understanding of the pros and cons of OAC treatment and, in patients with AF, decreased anxiety about therapeutic decisions and increased willingness to accept treatment options. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12911-023-02260-x.
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spelling pubmed-104638112023-08-30 Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation Chiu, Hsiao-Hui Chang, Shih-Lin Cheng, Hao-Min Chao, Tze-Fan Lin, Yenn-Jiang Lo, Li-Wei Hu, Yu-Feng Chung, Fa-Po Liao, Jo-Nan Tuan, Ta-Chuan Lin, Chin-Yu Chang, Ting-Yung Kuo, Ling Liu, Chih-Min Tsai, Yung-Nan Huang, Yu-Ting Chang, Yuh-Lih Wung, Ju-Chieh Chen, Shih-Ann BMC Med Inform Decis Mak Research BACKGROUND: Treatment with oral anticoagulants (OACs) could prevent stroke in atrial fibrillation (AF), but side effects developed due to OACs may cause patients anxiety during decision making. This study aimed to investigate whether shared decision making (SDM) reduces anxiety and improves adherence to stroke prevention measures in patients with AF. METHODS: A one-group pretest–posttest design using a questionnaire survey was applied at the outpatient cardiology clinic between July 2019 until September 2020. A Patient Decision Aid (PDA) tool was used for the completion of the questionnaire survey after health education and counseling. Ten questions were included for patients’ recognition of SDM, and a 5-point scoring method was used, where “very much” was scored as 5 points, and “totally not” was scored as 1 point. RESULTS: Fifty-two patients with AF were enrolled. In terms of patients’ recognition of SDM, points of more than 4.17 out of 5 were noted, indicating recognition above the level of “very much.” The patients’ anxiety scores before SDM were 3.56 (1.2), with a decrease of 0.64 points (p < 0.001) to 2.92 (1.3) after SDM. After SDM, the number of patients who decided to take OAC increased from 76.9% to 88.5%, and the 15.4% answering “unclear” decreased to 1.9% (p = 0.006). The patients’ anxiety levels after SDM were associated with gender (p = 0.025). CONCLUSIONS: The approach using SDM enhanced our understanding of the pros and cons of OAC treatment and, in patients with AF, decreased anxiety about therapeutic decisions and increased willingness to accept treatment options. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12911-023-02260-x. BioMed Central 2023-08-22 /pmc/articles/PMC10463811/ /pubmed/37608374 http://dx.doi.org/10.1186/s12911-023-02260-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Chiu, Hsiao-Hui
Chang, Shih-Lin
Cheng, Hao-Min
Chao, Tze-Fan
Lin, Yenn-Jiang
Lo, Li-Wei
Hu, Yu-Feng
Chung, Fa-Po
Liao, Jo-Nan
Tuan, Ta-Chuan
Lin, Chin-Yu
Chang, Ting-Yung
Kuo, Ling
Liu, Chih-Min
Tsai, Yung-Nan
Huang, Yu-Ting
Chang, Yuh-Lih
Wung, Ju-Chieh
Chen, Shih-Ann
Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation
title Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation
title_full Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation
title_fullStr Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation
title_full_unstemmed Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation
title_short Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation
title_sort shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463811/
https://www.ncbi.nlm.nih.gov/pubmed/37608374
http://dx.doi.org/10.1186/s12911-023-02260-x
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