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Updated: Dec 21, 2025
07:39
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
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Decision Aid Implementation among Left Ventricular Assist Device Programs Participating in the DECIDE-LVAD
Daniel D Matlock1,2,3, Colleen K McIlvennan4, Jocelyn S Thompson3
1Veterans Affairs Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA.
Summary
Patient decision aids (DAs) for left ventricular assist device (LVAD) decisions reached most patients, with high adoption by clinicians. Ongoing communication and addressing procedural volume concerns are key for sustained use.
Area of Science:
- Implementation Science
- Medical Device Technology
- Patient-Centered Care
Background:
- Patient decision aids (DAs) show efficacy but lack widespread clinical use without mandates.
- Left ventricular assist device (LVAD) decisions are complex and preference-sensitive, ideal for DA implementation.
Purpose of the Study:
- To evaluate the implementation and effectiveness of a DA for LVAD consideration.
- To assess patient reach, clinician adoption, and sustained use of the DA.
Main Methods:
- A type II effectiveness-implementation hybrid trial using a stepped-wedge cluster-randomized design.
- Utilized the RE-AIM framework, collecting quantitative data (DA use checklist) and qualitative data (clinician interviews).
Main Results:
- The DA reached 95% of eligible patients, with 100% site adoption.
- Clinicians strongly desired to inform patients but faced team communication challenges.
- Five of six sites maintained DA use post-trial; one cited concerns about decreased procedural volume.
Conclusions:
- The DA demonstrated high reach and adoption for LVAD decisions, driven by a commitment to patient information.
- Sustained implementation requires addressing procedural volume concerns and facilitating inter-team communication.
- Future research should focus on dissemination, coverage mandates, and communication strategies for DA use.
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