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心脏病学中的共享决策:系统评价和荟萃分析。

Shared decision making in cardiology: a systematic review and meta-analysis.

机构信息

Cardiology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Department of Cardiology, Royal Papworth Hospital, Cambridge, UK.

出版信息

Heart. 2022 Dec 13;109(1):34-39. doi: 10.1136/heartjnl-2022-321050.

Abstract

OBJECTIVES

To evaluate the effectiveness of interventions to improve shared decision making (SDM) in cardiology with particular focus on patient-centred outcomes such as decisional conflict.

METHODS

We searched Embase (OVID), the Cochrane library, PubMed and Web of Science electronic databases from inception to January 2021 for randomised controlled trials that investigated the effects of interventions to increase SDM in cardiology. The primary outcomes were decisional conflict, decisional anxiety, decisional satisfaction or decisional regret; a secondary outcome was knowledge gained by the patients.

RESULTS

Eighteen studies which reported on at least one outcome measure were identified, including a total of 4419 patients. Interventions to increase SDM had a significant effect on reducing decisional conflict (standardised mean difference (SMD) -0.211, 95% CI -0.316 to -0.107) and increasing patient knowledge (SMD 0.476, 95% CI 0.351 to 0.600) compared with standard care.

CONCLUSIONS

Interventions to increase SDM are effective in reducing decisional conflict and increasing patient knowledge in the field of cardiology. Such interventions are helpful in supporting patient-centred healthcare and should be implemented in wider cardiology practice.

摘要

目的

评估改善心脏病学中共享决策(SDM)的干预措施的有效性,特别关注以患者为中心的结果,如决策冲突。

方法

我们从建库至 2021 年 1 月,在 Embase(OVID)、Cochrane 图书馆、PubMed 和 Web of Science 电子数据库中搜索了旨在增加心脏病学中 SDM 的干预措施的随机对照试验,以评估其效果。主要结局是决策冲突、决策焦虑、决策满意度或决策后悔;次要结局是患者获得的知识。

结果

确定了 18 项报告了至少一项结局指标的研究,共纳入 4419 名患者。与标准护理相比,增加 SDM 的干预措施可显著降低决策冲突(标准化均数差(SMD)-0.211,95%CI-0.316 至-0.107)和提高患者知识(SMD 0.476,95%CI 0.351 至 0.600)。

结论

增加 SDM 的干预措施可有效降低心脏病学领域的决策冲突并提高患者知识。此类干预措施有助于支持以患者为中心的医疗保健,应在更广泛的心脏病学实践中实施。

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