1. Shared Decision-Making and Cardiovascular Health: A Scientific Statement From the American Heart Association.
- Author
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Dennison Himmelfarb, CR, Beckie, TM, Allen, LA, Commodore-Mensah, Y, Davidson, PM, Lin, G, Lutz, B, Spatz, ES, American Heart Association Council on Cardiovascular and Stroke Nursing, American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Quality of Care and Outcomes Research; Council on Hypertension; Council on the Kidney in Cardiovascular Disease; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; Council on Epidemiology and Prevention; and Stroke Council, Dennison Himmelfarb, CR, Beckie, TM, Allen, LA, Commodore-Mensah, Y, Davidson, PM, Lin, G, Lutz, B, Spatz, ES, American Heart Association Council on Cardiovascular and Stroke Nursing, and American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Quality of Care and Outcomes Research; Council on Hypertension; Council on the Kidney in Cardiovascular Disease; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; Council on Epidemiology and Prevention; and Stroke Council
- Abstract
Shared decision-making is increasingly embraced in health care and recommended in cardiovascular guidelines. Patient involvement in health care decisions, patient-clinician communication, and models of patient-centered care are critical to improve health outcomes and to promote equity, but formal models and evaluation in cardiovascular care are nascent. Shared decision-making promotes equity by involving clinicians and patients, sharing the best available evidence, and recognizing the needs, values, and experiences of individuals and their families when faced with the task of making decisions. Broad endorsement of shared decision-making as a critical component of high-quality, value-based care has raised our awareness, although uptake in clinical practice remains suboptimal for a range of patient, clinician, and system issues. Strategies effective in promoting shared decision-making include educating clinicians on communication techniques, engaging multidisciplinary medical teams, incorporating trained decision coaches, and using tools (ie, patient decision aids) at appropriate literacy and numeracy levels to support patients in their cardiovascular decisions. This scientific statement shines a light on the limited but growing body of evidence of the impact of shared decision-making on cardiovascular outcomes and the potential of shared decision-making as a driver of health equity so that everyone has just opportunities. Multilevel solutions must align to address challenges in policies and reimbursement, system-level leadership and infrastructure, clinician training, access to decision aids, and patient engagement to fully support patients and clinicians to engage in the shared decision-making process and to drive equity and improvement in cardiovascular outcomes.
- Published
- 2023