Shared Decision-Making in Cardiovascular Risk Factor Management: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiovascular Medicine
• Health Behavior Research
• Health Services Research

Background:

• The role of shared decision-making (SDM) in improving cardiovascular risk management is not fully understood.
• Existing interventions utilizing SDM require further evaluation for their effectiveness.

Approach:

• A systematic review and meta-analysis of randomized clinical trials (RCTs) was conducted.
• Searched multiple databases (Medline, CINAHL, Embase, Cochrane, Web of Science, Scopus, ClinicalTrials.gov) for studies up to June 24, 2022.
• Included 57 RCTs involving 88,578 patients and 1341 clinicians, synthesizing data using a random-effects model.

Key Points:

• SDM interventions were associated with a statistically significant decrease in decisional conflict (Decisional Conflict Scale scores).
• A modest but significant reduction in hemoglobin A1c (HbA1c) levels was observed in patients receiving SDM interventions.
• The quality of the included studies was generally low to fair, with substantial heterogeneity noted in the results.

Conclusions:

• SDM interventions demonstrate a potential to reduce decisional conflict and improve glycemic control (HbA1c) in cardiovascular risk management.
• The current evidence base is limited by study quality and heterogeneity, necessitating high-quality research.
• Further investigation is crucial to establish the definitive impact and optimal implementation of SDM in cardiovascular care.