We hypothesize that having patients determine critical components in the Shared Decision Making process (learning styles, barriers to decision making, and patient preferred outcomes) is critical to the success to the Shared Decision Making Process. Our approach 1) addresses the barriers to shared decision making, 2) improves clinician education; 3) trains a lay community patient coach.The central goal of the study is to determine whether a personalized, individually-tailored approach addressing decision making barriers combined with techniques of increasing clinician empathy and skills and use of a patient coach will be more effective in Shared Decision Making compared to best-practice decision aids alone. The specific aims of the proposed study are to:1.To develop and refine a simplified, easy-to-implement patient-designed assessment and interventional toolset developed using innovative design thinking tools to assess and address the barriers to Shared Decision Making in individual patients facing decisions regarding anticoagulation for stroke reduction in atrial fibrillation and to compare the toolset with existing validated instruments2.To develop, test, and document a training process that includes Clinician education and Patient Coach training that facilitates both implementation of the project and its future dissemination 3.To rigorously evaluate the comparative effectiveness of an innovative pathway consisting of these assessment and interventional toolsets, clinician education toolset, and patient coach training in improving the Shared Decision Making process and adherence in a wide range of individuals and settings, including patients with low health literacy and those in vulnerable populations. In the Project we conduct a Randomized Control Comparative Effectiveness trial comparing an Innovative Shared Decision Making Pathway with use of a conventional Decision Aid. Unique and/or noteworthy aspects of our approach include: 1) Use of a primary endpoint based on outcomes that patients in our study determine to be important and a toolset designed according to patient preferences; 2) Over-representation of vulnerable populations and patients with low health literacy; 3) Use of design thinking approaches to create innovative Shared Decision Making tools led by the global design firm IDEO; 4) Extensive planning for implementation throughout the study; 5) Governance completely by patient majority committees.
|Program type||Strategically Focused Research Network|
|Effective start/end date||07/01/2018 → 06/30/2022|