Zheng Haoyang, Zhang Duo, Xiang Wei, Wu Yuxi, Peng Zesheng, Gan Yong, Chen Shengcai
Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China.
Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030 Wuhan, Hubei, China.
Rev Cardiovasc Med. 2023 Aug 25;24(8):246. doi: 10.31083/j.rcm2408246. eCollection 2023 Aug.
Coronary heart disease (CHD) is the leading cause of death in the world. There are some decision-making conflicts in the management of chest pain, treatment methods, stent selection, and other aspects due to the unstable condition of CHD in the treatment stage. Although using decision aids to facilitate shared decision-making (SDM) contributes to high-quality decision-making, it has not been evaluated in the field of CHD. This review systematically assessed the effects of SDM in patients with CHD.
We conducted a systematic review and meta-analysis of randomized controlled trials of SDM interventions in patients with CHD from database inception to 1 June 2022 (PROSPERO [Unique identifier: CRD42022338938]). We searched for relevant studies in the PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wan Fang databases. The primary outcomes were knowledge and decision conflict. The secondary outcomes were satisfaction, patient participation, trust, acceptance, quality of life, and psychological condition.
A total of 8244 studies were retrieved. After screening, ten studies were included in the analysis. Compared with the control group, SDM intervention with patient decision aids obviously improved patients' knowledge, decision satisfaction, participation, and medical outcomes and reduced decision-making conflict. There was no significant effect of SDM on trust.
This study showed that SDM intervention in the form of decision aids was beneficial to decision-making quality and treatment outcomes among patients with CHD. The results of SDM interventions need to be evaluated in different environments.
冠心病（CHD）是全球主要的死亡原因。在冠心病治疗阶段，由于病情不稳定，胸痛管理、治疗方法、支架选择等方面存在一些决策冲突。尽管使用决策辅助工具促进共同决策（SDM）有助于高质量决策，但尚未在冠心病领域进行评估。本综述系统评价了SDM对冠心病患者的影响。
我们对从数据库建立至2022年6月1日（PROSPERO [唯一标识符：CRD42022338938]）的冠心病患者SDM干预随机对照试验进行了系统评价和荟萃分析。我们在PubMed、Embase、Cochrane图书馆、Web of Science、中国知网和万方数据库中检索相关研究。主要结局为知识和决策冲突。次要结局为满意度、患者参与度、信任度、接受度、生活质量和心理状况。
共检索到8244项研究。筛选后，纳入分析的研究有10项。与对照组相比，使用患者决策辅助工具的SDM干预明显提高了患者的知识水平、决策满意度、参与度和医疗结局，并减少了决策冲突。SDM对信任度无显著影响。
本研究表明，以决策辅助工具形式进行的SDM干预有利于冠心病患者的决策质量和治疗结局。SDM干预的结果需要在不同环境中进行评估。
