Related Experiment Video

Updated: Oct 19, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.6K

Decision aids for shared decision-making and appropriate anticoagulation therapy in patients with atrial

Dan Song1, Jie Zhou1, Tianli Fan1

  • 1Shenzhen Qianhai and Shekou Free Trade Zone Hospital, No. 36, 7th Industrial Road, Nanshan District, Shenzhen City, Guangdong Province 518067, P.R. China.

European Journal of Cardiovascular Nursing
|September 22, 2021
PubMed

Insights

Decision aids (DAs) improve shared decision-making (SDM) and oral anticoagulant (OAC) uptake in atrial fibrillation (AF) patients. Evidence on OAC adherence and stroke/bleeding risk reduction remains uncertain, requiring further research.

Area of Science:

  • Cardiology
  • Evidence-Based Medicine
  • Health Services Research

Background:

  • Underuse of oral anticoagulants (OACs) is a significant issue in atrial fibrillation (AF) management, impacting stroke prevention.
  • Shared decision-making (SDM) is crucial for enhancing treatment adherence and aligning care with patient preferences.
  • Decision aids (DAs) are tools designed to facilitate SDM in clinical practice.

Purpose of the Study:

  • To evaluate the impact of DAs on AF patients' knowledge, decisional conflict, OAC uptake, and adherence.
  • To assess the effect of DAs on the incidence of stroke and bleeding in AF patients.
  • To identify factors associated with improved effectiveness of DAs in promoting SDM and OAC use.

Main Methods:

  • A systematic literature search was conducted across five databases.
  • Meta-analysis was performed using RevMan 5.3 where data permitted.
  • Comparative analysis identified characteristics of effective DAs, focusing on SDM elements and delivery methods.

Main Results:

  • DAs significantly reduced decisional conflict regarding warfarin use (MD = -0.10, 95% CI: -0.18 to -0.02, P=0.01).
  • DAs enhanced OAC uptake (RR = 1.03, 95% CI: 1.01-1.05, P=0.004).
  • The effects of DAs on adherence, stroke, and bleeding incidence remain unclear. Effective DAs incorporated key SDM elements and were delivered pre-consultation.

Conclusions:

  • Decision aids show promise in promoting SDM and OAC uptake among AF patients.
  • Further rigorous trials with extended follow-up are needed to clarify the impact of DAs on adherence and clinical outcomes (stroke/bleeding).
  • Specific DA design features, including comprehensive SDM components and pre-consultation delivery, are associated with greater effectiveness.
Abstract

Keywords:
Atrial fibrillationDecision aidsOral anticoagulantsShared decision-makingStroke prevention

More Related Videos

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

83.9K
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

3.9K

Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.5K
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
60
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
1.1K
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
67
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
762
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
66