Shared Decision-Making for Patients Hospitalized with Acute Myocardial Infarction: A Randomized Trial

Megan E Branda,1,2 Marleen Kunneman,1,3 Alejandra I Meza-Contreras,1,4 Nilay D Shah,5 Erik P Hess,6 Annie LeBlanc,7 Jane A Linderbaum,4 Danika M Nelson,4 Margaret R Mc Donah,8 Carrie Sanvick,9 Holly K Van Houten,10 Megan Coylewright,11 Sara R Dick,12 Henry H Ting,5 Victor M Montori1 1Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA; 2Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA; 3Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands; 4Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA; 5Delta Air Lines, Atlanta, GA, USA; 6Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; 7Faculty of Medicine, Laval University, Quebec City, Quebec, Canada; 8Mayo Clinic Health System, Mayo Clinic, Rochester, MN, USA; 9Department of Nursing, Mayo Clinic, Rochester, MN, USA; 10Robert D and Patricia E Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; 11Section of Cardiovascular Medicine, Erlanger Heart and Lung Institute, Chattanooga, TN, USA; 12Education Project Management Office, Mayo Clinic, Rochester, MN, USACorrespondence: Victor M Montori, 200 First Street SW, Rochester, MN, 55905, USA, Tel +1 507-284-2511, Email Montori.victor@mayo.eduObjective: Adherence to guideline-recommended medications after acute myocardial infarction (AMI) is suboptimal. Patient fidelity to treatment regimens may be related to their knowledge of the risk of death following AMI, the pros and cons of medications, and to their involvement in treatment decisions. Shared decision-making may improve both patients’ knowledge and involvement in treatment decisions.Methods: In a pilot trial, patients hospitalized with AMI were randomized to the use of the AMI Choice conversation tool or to usual care. AMI Choice includes a