Developing Shared Decision-Making Workflow for Cardiovascular Health: A Modified Delphi Process

National guidelines recommend implementing team-based care and shared decision-making (SDM) for improving hypertension control and cardiovascular health. However, best practices for integrating SDM into clinical workflows for health behavior change and medication management in adults with hypertension and multiple cardiovascular disease (CVD) risk factors remains unclear. The study aimed to develop SDM workflows to inform design of patient decision aids to support health behavior change and medication management of adults with hypertension and multiple CVD risk factors.

This study used a modified Delphi method with a geographically diverse panel of 18 interprofessional team members. The process included two Rounds of online Delphi surveys between May and October 2024, followed by a virtual panel meeting in November 2024. Consensus was defined as ≥75% of panelists rating items of the SDM workflow as important or very important with each Round of the online Delphi surveys.

Of the 18 expert panelists, the majority were female (n = 15, 83.3%) with a mean age of 49.8 years (standard deviation: 12.9). The Delphi process resulted in two SDM workflows to improve health behavior change and medication management: one with 70 items focused on hypertension control, and another with 75 items addressing the management of multiple CVD risk factors.

The study developed two SDM workflows to support hypertension control and CVD risk factor management. These workflows offer a structured approach to integrating SDM into clinical practice and may serve as a guide for designing patient decision aids in cardiovascular health.