Coronary Artery Disease
Conditions
Keywords
Shared Decision Making, Percutaneous Coronary Intervention (PCI), Coronary Artery Bypass Grafting (CABG)
Brief summary
Together with patients and healthcare professionals, we want to design a Decision Support Tool (DST) that will help people with coronary artery disease to understand and choose treatments that best reflect their preferences and values. Coronary artery disease (CAD) is a leading cause of death. Blood vessels supplying oxygen to the heart muscle become narrowed by a gradual build-up of fatty material. This can result in heart attacks, heart failure, and sudden death. One way to treat the blockage is by inserting an inner sleeve called a stent into the blood vessel and clearing the blockage by forcing it into the artery wall. Another method involves diverting the blood supply around the blockage using a vessel harvested from another body site; this is called bypass surgery. The best treatment, either stents or surgery, is different for everyone. A Decision Support Tool (DST) will provide key information on the pros and cons of stents or surgery and how these match an individual's preferences and values. People are then empowered to make shared decisions about treatment with their doctors. Personalising treatment decisions in this way can reduce inequalities in care and improve shared decision making. Our proposed research will develop a DST in the form of a webpage with alternative print material for those at risk of digital poverty. The DST will be developed in multiple languages to improve accessibility. There are two parts to the study: the first part will use the experience of patients, who have already had stent or surgery, and healthcare professionals to design and refine a DST prototype; this will be done through workshops, focus groups, and cognitive interviews. The second part will test whether it is possible to use the DST by people with CAD waiting for a procedure; this will be done through questionnaires and interviews. The result of this study can then subsequently inform an assessment of the refined DST on a national level, with the hopes of enabling more effective shared decision making.
Interventions
OTHERDecision Support Tool (DECIDE-CAD)
DECIDE-CAD is a decision support tool - designed using mixed methods through this study - which aims to enable shared decision making with people who are considering revascularisation options for coronary artery disease.
Sponsors
University Hospitals, Leicester
University of Leicester
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
WP1. DST CO-DESIGN PATIENT PARTICIPANTS Inclusion Criteria Participants may enter the study if ALL of the following applies: 1. Any adult (≥ 18 years) with lived experience of coronary revascularisation 2. Willing and able to consent to study participation. 3. Able to understand written and spoken English for decisional needs workshop or focus groups (NB this criterion is not required for cognitive interviews or acceptability questionnaire)
Exclusion criteria
Participants may not enter the study if they are unable to provide informed consent. Individuals who participate in focus groups are ineligible for subsequent participation in cognitive interviews and acceptability questionnaires. WP1. DST CO-DESIGN HCP PARTICIPANTS Inclusion Criteria Participants may enter the study if ALL of the following applies: 1. Healthcare professional with a patient-facing clinical role which involves decision making regarding coronary revascularisation 2. Willing and able to consent to study participation. 3. Able to understand written and spoken English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of eligibility | 6 months | Eligibility will be calculated as all patients eligible for study participation as a proportion of all patients who receive ACS treatment during the study period. |
| Rate of enrolment | 6 months | Enrolment will be calculated as patients who provide informed consent and receive the DST as a proportion of all eligible patients. |
| Rate of attrition | 6 months | Attrition will be calculated as patients who do not complete the study as a proportion of all patients enrolled. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Preference | 6 weeks | User preference about revascularisation options, measured using Control Preference Scale and Patients Preferences Questionnaire for Angina treatment before and after revascularisation procedure. |
| Satisfaction with decision | 6 weeks | User satisfaction with decision, measured using Satisfaction with Decision Scale after revascularisation procedure. |
| Decision Regret | 6 weeks | Degree of decision regret about revascularisation treatment received, measured using Decision Regret Scale after revascularisation procedure |
| Decisional Conflict | 6 weeks | Level of decisional conflict, measured using Decisional Conflict Scale before and after revascularisation procedure. |
| Level of shared decision making | 6 weeks | Level of shared decision making experienced by the user, measured using Shared Decision Making Questionnaire (SDM-Q-9) after revascularisation procedure. |
| Health status | 6 weeks | Health status measured using 20-item Short Form Survey before and after revascularisation procedure. |
| Treatment concordance | 6 weeks | Concordance between user's preferred procedure and the treatment received, assessed after revascularisation procedure. |
| Acceptability | 6 weeks | User acceptability of decision support tool, measured using researcher-generated questionnaire after revascularisation procedure. |
| Knowledge | 6 weeks | User knowledge about revascularisation options, measured using researcher-regenerated questionnaire before and after revascularisation procedure. |
Countries
United Kingdom
Contacts
Primary ContactDr Ann Cheng
Outcome results
None listed