Shared decision making for stroke prevention in atrial fibrillation (SDM4Afib)
心房颤动中风预防的共同决策 (SDM4Afib)
基本信息
- 批准号:9076319
- 负责人:
- 金额:$ 75.4万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2016
- 资助国家:美国
- 起止时间:2016-04-01 至 2021-03-31
- 项目状态:已结题
- 来源:
- 关键词:AdherenceAdultAffectAmericanAmerican Heart AssociationAnticoagulantsAnticoagulationArrhythmiaAtrial FibrillationAttentionCardiologyCardiovascular systemCaringCessation of lifeChronicClinicClinicalCommunitiesDecision MakingDependenceDietDrug PrescriptionsEnrollmentEnsureEvidence based practiceFaceFeedbackGoalsGuidelinesHemorrhageInterventionLifeMeasuresMedical RecordsMonitorOutcomePatient riskPatientsPharmaceutical PreparationsPharmacy facilityProcessPublic HealthPublishingQuestionnairesRandomizedRecommendationRegimenRelative RisksRiskSafetySocial EnvironmentSocietiesStrokeStroke preventionSubgroupTestingTimeTranslatingTravelVideo RecordingVisitVitamin KWarfarinWomanWorkbasecollegecompliance behaviorcostdesigndisabilityexperienceheart rhythmhigh riskimprovedliteracymathematical abilitymedical attentionmeetingsneighborhood safetypreferencepublic health relevancerandomized trialresponsesafety netshared decision makingsupport toolstooltreatment as usualtrial designuser centered design
项目摘要
DESCRIPTION (provided by applicant): Chronic nonvalvular Atrial fibrillation (AF) is a very common and costly public health problem. AF may reduce the quality and duration of life, both, particularly by increasing the risk of devastating thromboembolic strokes. Anticoagulants, including vitamin K antagonists (VKAs, e.g., warfarin) and non-VKA anticoagulants (NOACs, e.g., dabigatran, -xabans), are very effective, but underused treatments. Anticoagulation underuse results form challenges clinicians face in prescribing these drugs and patients face in implementing their use in their lives. Recognizing these challenges, leading cardiovascular societies in 2014 formulated a class I recommendation of shared decision making (SDM) for the individualization of anticoagulation therapy in at-risk patients with AF. However, there are no proven interventions to support the implementation of this recommendation, and no evidence of the effect of SDM on the problem of initiating and implementing anticoagulation. With over a decade of experience, we have demonstrated the practical impact of SDM interventions in other contexts. Building on this experience, we propose to use an SDM tool we developed using user-centered design, ANTICOAGULATION CHOICE, to promote SDM about anticoagulation between patients with AF and their clinicians. Using a randomized trial design, we plan to determine the impact of using this tool on the quality of SDM and on the rate of anticoagulation and patient adherence to this therapy. By generating reliable practice-based evidence, this trial can provide feedback to the guideline panel about the impact of SDM on the quality of individualized anticoagulation care. We propose to enroll 999 adult patients with chronic nonvalvular AF deemed at high risk of thromboembolic strokes (CHA2DS2-VASc score ≥ 1, or 2 in women) and receiving care in academic, community, or safety net clinics. We plan to randomly assign them to care with or without a new SDM tool, ANTICOAGULATION CHOICE. Trial outcomes include the quality of SDM (primary endpoint, aim 1), the rate of anticoagulation, the distribution of anticoagulants chosen, and patient adherence to anticoagulation at 12 months (aim 2). If successful, this work will reduce the underuse of anticoagulation therapy and improve the care and outcomes of millions of patients with AF.
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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VICTOR MANUEL MONTORI其他文献
VICTOR MANUEL MONTORI的其他文献
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{{ truncateString('VICTOR MANUEL MONTORI', 18)}}的其他基金
Implementing Shared Decision Making (SDM) for Individualized CV Prevention (SDM4IP)
实施共享决策 (SDM) 以实现个体化心血管预防 (SDM4IP)
- 批准号:
10611866 - 财政年份:2020
- 资助金额:
$ 75.4万 - 项目类别:
Implementing Shared Decision Making (SDM) for Individualized CV Prevention (SDM4IP)
实施共享决策 (SDM) 以实现个体化心血管预防 (SDM4IP)
- 批准号:
10392952 - 财政年份:2020
- 资助金额:
$ 75.4万 - 项目类别:
Shared decision making for stroke prevention in atrial fibrillation (SDM4Afib)
心房颤动中风预防的共同决策 (SDM4Afib)
- 批准号:
9246591 - 财政年份:2016
- 资助金额:
$ 75.4万 - 项目类别:
Shared decision making for stroke prevention in atrial fibrillation (SDM4Afib)
心房颤动中风预防的共同决策 (SDM4Afib)
- 批准号:
9898425 - 财政年份:2016
- 资助金额:
$ 75.4万 - 项目类别:
Shared decision making for stroke prevention in atrial fibrillation (SDM4Afib)
心房颤动中风预防的共同决策 (SDM4Afib)
- 批准号:
9261196 - 财政年份:2016
- 资助金额:
$ 75.4万 - 项目类别:
Patient centered dissemination of evidence-based medicine - SHARE EBM
以患者为中心的循证医学传播 - SHARE EBM
- 批准号:
8793180 - 财政年份:2013
- 资助金额:
$ 75.4万 - 项目类别:
Patient centered dissemination of evidence-based medicine - SHARE EBM
以患者为中心的循证医学传播 - SHARE EBM
- 批准号:
8471311 - 财政年份:2013
- 资助金额:
$ 75.4万 - 项目类别:
Patient centered dissemination of evidence-based medicine - SHARE EBM
以患者为中心的循证医学传播 - SHARE EBM
- 批准号:
8643209 - 财政年份:2013
- 资助金额:
$ 75.4万 - 项目类别:
Translation of comparative effectiveness of depression medications into practice
将抑郁症药物的比较有效性转化为实践
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8007031 - 财政年份:2010
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$ 75.4万 - 项目类别:
The Impact of Decision Aids to Enhance Shared Decision Making for Diabetes
决策辅助对增强糖尿病共同决策的影响
- 批准号:
7699932 - 财政年份:2009
- 资助金额:
$ 75.4万 - 项目类别:
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