Effects of Shared Decision-Making with a Patient Decision Aid for Postangiography Hemostasis Method Selection: A Randomized Controlled Trial

Abstract

PurposeTo evaluate the effects of shared decision-making (SDM) with a patient decision aid (PtDA) on hemostasis device selection and reduction of decisional conflicts in patients undergoing transfemoral angiography. Materials and MethodsPatients undergoing angiography were randomized to receive either a standard explanation or the process aid of PtDA for choosing hemostasis devices. The decisional conflict was assessed using the 4-item Sure of myself; Understand information; Risk-benefit ratio; Encouragement (SURE) scale. Differences in demographic variables, clinical variables, and final choice of hemostasis devices were compared via univariate and multivariate logistic regression analyses. ResultsIn total, 158 patients were included—80 in the PtDA group and 78 in the standard group. No difference was found between the 2 groups in terms of patient demographic and clinical variables. The PtDA group scored better on all questions of the SURE scale both individually and collaboratively (P <.001). PtDA intervention (P =.031) and reason for angiography (P =.0006) were the main variables that influenced patient hemostasis device choice in the univariate logistic regression analysis. Reason for angiography remained the only deciding factor that affected patient choice in the multivariate logistic regression analysis (P =.015). ConclusionsStep-by-step guidance and pictorial explanation with the assistance of PtDA led to improvements in patient knowledge but showed no significant impact in multivariate analysis for the influence on the choice of hemostasis device.