Shared decision‐making for older adults with cardiovascular disease
Shared decision‐making is appropriate for clinical decisions involving multiple reasonable options, which occur frequently in the cardiovascular care of older adults. The process includes the communication of relevant factual information between the patient and the clinician, elicitation of patient...
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| Published in: | Clinical cardiology (Mahwah, N.J.) Vol. 43; no. 2; pp. 196 - 204 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
New York
Wiley Periodicals, Inc
01.02.2020
John Wiley & Sons, Inc |
| Subjects: | |
| ISSN: | 0160-9289, 1932-8737, 1932-8737 |
| Online Access: | Get full text |
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| Abstract | Shared decision‐making is appropriate for clinical decisions involving multiple reasonable options, which occur frequently in the cardiovascular care of older adults. The process includes the communication of relevant factual information between the patient and the clinician, elicitation of patient preferences, and a mutual agreement on the best course of action to meet the patient's personal goals. For older adults, there are common challenges and considerations with regard to shared decision‐making, some of which (eg, cognitive impairment) may be biologically linked to cardiovascular disease. There are tools designed to facilitate the shared decision‐making process, known as decision aids, which are broadly effective although have shortcomings when applied to older adults. Novel approaches in clinical research and health systems changes will go some way toward improving shared decision‐making for older adults, but the greatest scope for improvement may be within the grass roots areas of communication skills, interdisciplinary teamwork, and simply asking our patients what matters most. |
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| AbstractList | Shared decision-making is appropriate for clinical decisions involving multiple reasonable options, which occur frequently in the cardiovascular care of older adults. The process includes the communication of relevant factual information between the patient and the clinician, elicitation of patient preferences, and a mutual agreement on the best course of action to meet the patient's personal goals. For older adults, there are common challenges and considerations with regard to shared decision-making, some of which (eg, cognitive impairment) may be biologically linked to cardiovascular disease. There are tools designed to facilitate the shared decision-making process, known as decision aids, which are broadly effective although have shortcomings when applied to older adults. Novel approaches in clinical research and health systems changes will go some way toward improving shared decision-making for older adults, but the greatest scope for improvement may be within the grass roots areas of communication skills, interdisciplinary teamwork, and simply asking our patients what matters most.Shared decision-making is appropriate for clinical decisions involving multiple reasonable options, which occur frequently in the cardiovascular care of older adults. The process includes the communication of relevant factual information between the patient and the clinician, elicitation of patient preferences, and a mutual agreement on the best course of action to meet the patient's personal goals. For older adults, there are common challenges and considerations with regard to shared decision-making, some of which (eg, cognitive impairment) may be biologically linked to cardiovascular disease. There are tools designed to facilitate the shared decision-making process, known as decision aids, which are broadly effective although have shortcomings when applied to older adults. Novel approaches in clinical research and health systems changes will go some way toward improving shared decision-making for older adults, but the greatest scope for improvement may be within the grass roots areas of communication skills, interdisciplinary teamwork, and simply asking our patients what matters most. Shared decision‐making is appropriate for clinical decisions involving multiple reasonable options, which occur frequently in the cardiovascular care of older adults. The process includes the communication of relevant factual information between the patient and the clinician, elicitation of patient preferences, and a mutual agreement on the best course of action to meet the patient's personal goals. For older adults, there are common challenges and considerations with regard to shared decision‐making, some of which (eg, cognitive impairment) may be biologically linked to cardiovascular disease. There are tools designed to facilitate the shared decision‐making process, known as decision aids, which are broadly effective although have shortcomings when applied to older adults. Novel approaches in clinical research and health systems changes will go some way toward improving shared decision‐making for older adults, but the greatest scope for improvement may be within the grass roots areas of communication skills, interdisciplinary teamwork, and simply asking our patients what matters most. |
| Author | Backman, Warren D. Harold, John Gordon Levine, Sharon A. Wenger, Nanette K. |
| AuthorAffiliation | 2 Section of Geriatrics Boston University and Boston Medical Center Boston Massachusetts 3 Division of Palliative Care and Geriatric Medicine Massachusetts General Hospital Boston Massachusetts 1 Veterans Affairs New England Geriatric Research Education and Clinical Center Boston Massachusetts 7 Cedars‐Sinai Smidt Heart Institute and UCLA David Geffen School of Medicine Los Angeles California 6 Emory Women's Heart Center Atlanta Georgia 4 Division of Cardiology Emory University School of Medicine Atlanta Georgia 5 Emory Heart and Vascular Center Atlanta Georgia |
| AuthorAffiliation_xml | – name: 2 Section of Geriatrics Boston University and Boston Medical Center Boston Massachusetts – name: 3 Division of Palliative Care and Geriatric Medicine Massachusetts General Hospital Boston Massachusetts – name: 6 Emory Women's Heart Center Atlanta Georgia – name: 7 Cedars‐Sinai Smidt Heart Institute and UCLA David Geffen School of Medicine Los Angeles California – name: 1 Veterans Affairs New England Geriatric Research Education and Clinical Center Boston Massachusetts – name: 4 Division of Cardiology Emory University School of Medicine Atlanta Georgia – name: 5 Emory Heart and Vascular Center Atlanta Georgia |
| Author_xml | – sequence: 1 givenname: Warren D. orcidid: 0000-0001-6391-0325 surname: Backman fullname: Backman, Warren D. organization: Boston University and Boston Medical Center – sequence: 2 givenname: Sharon A. surname: Levine fullname: Levine, Sharon A. organization: Massachusetts General Hospital – sequence: 3 givenname: Nanette K. orcidid: 0000-0003-0990-6151 surname: Wenger fullname: Wenger, Nanette K. organization: Emory Women's Heart Center – sequence: 4 givenname: John Gordon orcidid: 0000-0001-6475-4002 surname: Harold fullname: Harold, John Gordon email: john.harold@cshs.org organization: Cedars‐Sinai Smidt Heart Institute and UCLA David Geffen School of Medicine |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31580493$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | 2019 The Authors. published by Wiley Periodicals, Inc. 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| Keywords | cardiovascular disease geriatrics elderly shared decision-making aged older adults clinical decision-making decision aids decision-making capacity geriatric cardiology informed decision-making patient centered care |
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| License | Attribution 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
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