STudying Effectiveness in Patient-centered care

Project: SFRN


  • Angela Fagerlin (CD)


The STudying Effectiveness in Patient-centered care (STEP UP-AF) Center takes as its mission to determine which type of decision aid (DA) most effectively promotes shared decision making (SDM) to improve the quality and patient-centeredness of care for patients diagnosed with atrial fibrillation (AF), and to increase the uptake of appropriate anticoagulation treatment, leading to improved health outcomes (e.g., stroke prevention) in diverse patient populations.The Center's 2 projects will accomplish these specific aims: 1) determining the state of the field of DAs for patients diagnosed with AF; 2) adapting and developing DAs for use by patients before a clinician's visit (patient DAs) or patients and clinicians together (encounter DAs); and 3) filling evidence gaps regarding the most effective DA approach-patient DA, encounter DA, or both-for improving the quality of SDM and the utilization and adherence to anticoagulation therapy. The Center will leverage multidisciplinary expertise from clinician-scientists in Cardiology and Pharmacy; and from researchers from Population Health Sciences at University of Utah and Knowledge and Evaluation Research Unit at Mayo, in the design and evaluation of DAs, randomized trials, and community engagement. Victor Montori, MD's project "SODA-AF: The Scan & Optimization of Decision Aids for Atrial Fibrillation" will complete an environmental scan of the literature (published and unpublished) for the most effective AF DAs. Following the scan, we will update and adapt the best tools resulting in a patient and an encounter DA equivalent in content, differing only in method of delivery.Elissa Ozanne, PhD's project "RED-AF: Randomized Evaluation of Decision Support Interventions for Atrial Fibrillation" will then test the 2 DAs across a diverse population of AF patients in a randomized controlled trial to determine which DA most effectively improves SDM and patient outcomes. We will also test whether the success of the tools differs across patient subgroups.Fellow Training. By integrating fellows into projects and providing them with many collaborative opportunities, we will train the next generation of leaders in SDM.By study conclusion, the STEP UP-AF team will have successfully: 1) addressed significant evidence gaps in SDM, 2) created an effective DA that will improve SDM and the appropriate use of anticoagulation therapy in patients with AF, and 3) trained the next generation of scientists.
Award amount$1,044,745.00
Award date07/01/2018
Program typeStrategically Focused Research Network
Award ID18SFRN34110489
Effective start/end date07/01/201806/30/2022