TY - JOUR
T1 - What helps the successful implementation of digital decision aids supporting shared decision-making in cardiovascular diseases? A systematic review
AU - Peters, Loes J.
AU - Torres-Castaño, Alezandra
AU - van Etten-Jamaludin, Faridi S.
AU - Perestelo Perez, Lilisbeth
AU - Ubbink, Dirk T.
N1 - Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Aims: Although digital decision aids (DAs) have been developed to improve shared decision-making (SDM), also in the cardiovascular realm, its implementation seems challenging. This study aims to systematically review the predictors of successful implementation of digital DAs for cardiovascular diseases. Methods and results: Searches were conducted in MEDLINE, Embase, PsycInfo, CINAHL, and the Cochrane Library from inception to November 2021. Two reviewers independently assessed study eligibility and risk of bias. Data were extracted by using a predefined list of variables. Five good-quality studies were included, involving data of 215 patients and 235 clinicians. Studies focused on DAs for coronary artery disease, atrial fibrillation, and end-stage heart failure patients. Clinicians reported DA content, its effectivity, and a lack of knowledge on SDM and DA use as implementation barriers. Patients reported preference for another format, the way clinicians used the DA and anxiety for the upcoming intervention as barriers. In addition, barriers were related to the timing and Information and Communication Technology (ICT) integration of the DA, the limited duration of a consultation, a lack of communication among the team members, and maintaining the hospital's number of treatments. Clinicians' positive attitude towards preference elicitation and implementation of DAs in existing structures were reported as facilitators. Conclusion: To improve digital DA use in cardiovascular diseases, the optimum timing of the DA, training healthcare professionals in SDM and DA usage, and integrating DAs into existing ICT structures need special effort. Current evidence, albeit limited, already offers advice on how to improve DA implementation in cardiovascular medicine.
AB - Aims: Although digital decision aids (DAs) have been developed to improve shared decision-making (SDM), also in the cardiovascular realm, its implementation seems challenging. This study aims to systematically review the predictors of successful implementation of digital DAs for cardiovascular diseases. Methods and results: Searches were conducted in MEDLINE, Embase, PsycInfo, CINAHL, and the Cochrane Library from inception to November 2021. Two reviewers independently assessed study eligibility and risk of bias. Data were extracted by using a predefined list of variables. Five good-quality studies were included, involving data of 215 patients and 235 clinicians. Studies focused on DAs for coronary artery disease, atrial fibrillation, and end-stage heart failure patients. Clinicians reported DA content, its effectivity, and a lack of knowledge on SDM and DA use as implementation barriers. Patients reported preference for another format, the way clinicians used the DA and anxiety for the upcoming intervention as barriers. In addition, barriers were related to the timing and Information and Communication Technology (ICT) integration of the DA, the limited duration of a consultation, a lack of communication among the team members, and maintaining the hospital's number of treatments. Clinicians' positive attitude towards preference elicitation and implementation of DAs in existing structures were reported as facilitators. Conclusion: To improve digital DA use in cardiovascular diseases, the optimum timing of the DA, training healthcare professionals in SDM and DA usage, and integrating DAs into existing ICT structures need special effort. Current evidence, albeit limited, already offers advice on how to improve DA implementation in cardiovascular medicine.
KW - Barriers
KW - Cardiovascular diseases
KW - Decision aids
KW - Digital tools
KW - Facilitators
KW - Implementation
KW - Shared decision-making
UR - http://www.scopus.com/inward/record.url?scp=85153897415&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ehjdh/ztac070
DO - https://doi.org/10.1093/ehjdh/ztac070
M3 - Review article
C2 - 36743877
SN - 2634-3916
VL - 4
SP - 53
EP - 62
JO - European heart journal. Digital health
JF - European heart journal. Digital health
IS - 1
ER -