Shared Decision Making Guidance Reminders in Practice (SDM-GRIP).

Area of Science:

• Health Services Research
• Clinical Decision Support
• Patient-Centered Care

Background:

• Shared decision-making (SDM) is crucial for guiding treatment choices in stable coronary artery disease (CAD).
• Existing systems may not adequately support SDM prior to percutaneous coronary intervention (PCI) decisions.

Purpose of the Study:

• To develop and evaluate SDM-GRIP (Shared Decision Making Guidance Reminders in Practice), a system to enhance SDM in primary care for CAD patients.
• To assess the feasibility and reception of SDM-GRIP components before PCI decisions.

Main Methods:

• Program evaluation of SDM-GRIP, including provider training, decision aids, patient group visits, and SDM provider visits.
• Assessed participation rates for physician training and patient engagement in group visits and SDM encounters.

Main Results:

• Physician training participation was high (73%).
• Patient engagement in group visits (25%) and SDM visits (16%) was lower.
• 82% of providers used the encounter decision guide during SDM visits; patients valued the program and reimbursement was routine.

Conclusions:

• SDM-GRIP program elements were well-received and feasible.
• Low recruitment for educational group visits necessitates implementation adjustments.
• Future implementation will focus on integrating SDM tools at the point of stress test ordering to improve care coordination.