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Perspectivas sobre la toma de decisiones después de la prueba de estrés y resultados preferidos entre los adultos

Krishna K Patel^1,2,3, Tansu Eris^1,2,3, Christina M Pacheco⁴

¹Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

JAMA network open

|August 26, 2025

Resumen

Los adultos mayores que se someten a pruebas de estrés quieren más discusión sobre temas relacionados con la edad y valoran la calidad de vida. La integración de evaluaciones geriátricas en la toma de decisiones compartida puede mejorar la atención cardíaca centrada en el paciente.

Área de la Ciencia:

Medicina para la edad avanzada
Cardiología
Atención centrada en el paciente

Sus antecedentes:

La imagen de estrés no invasiva es común para la enfermedad arterial coronaria en adultos mayores.
Las condiciones geriátricas aumentan la vulnerabilidad a las complicaciones de las pruebas invasivas.

Objetivo del estudio:

Explorar las actitudes de los adultos mayores y los cuidadores sobre la toma de decisiones y los resultados deseados de las imágenes posteriores al estrés.
Comprender la influencia de las discapacidades geriátricas en estas decisiones.

Principales métodos:

Estudio cualitativo utilizando grupos focales con pacientes (≥75 años) y cuidadores.
Análisis temático de las discusiones sobre la comunicación paciente-médico, las preferencias de toma de decisiones y los factores geriátricos.
Método comparativo constante utilizado para la identificación de temas.

Principales resultados:

Los participantes deseaban una mayor discusión sobre los desafíos relacionados con la edad y el apoyo médico para tomar decisiones informadas.
La confianza en los médicos influyó en la participación del paciente en la toma de decisiones.
La calidad de vida y la independencia fueron priorizadas sobre la longevidad, moldeadas por condiciones crónicas y estado funcional.

Conclusiones:

Los adultos mayores desean una mejor comunicación con respecto a las preocupaciones relacionadas con la edad y valoran la opinión de los cuidadores.
La toma de decisiones compartida que incorpora evaluaciones geriátricas y objetivos de los pacientes puede mejorar la atención para esta población.

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