Development of a patient decision aid for people with refractory angina: protocol for a three-phase pilot study

Health and Quality of Life Outcomes

Dawn Stacey⁹  Peter Coyte⁸  Bonnie Stevens⁸  William McDonald⁶  Louise Malysh⁶  Joel Niznick^1,10  Ada Andrade⁵  John George Hanlon⁵  Nelson Svorkdal²  James Stone³  Marie-Gabrielle Lessard⁴  Etienne Marc Jolicoeur⁴  Robert McKelvie⁷  Joseph Charles Victor⁸  Heather Mary Arthur¹  Kelly Metcalfe⁸  Sandra Lee Carroll¹  Michael Hugh McGillion⁸ 

[1] Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton ON, L8N 3Z5, Canada;Royal Jubilee Hospital, 1952 Bay Street, Victoria V8R 1J8, BC, Canada;Libin Cardiovascular Institute of Alberta, University of Calgary, C823, 1403 - 29th Street NW, Calgary T2N 2T9 AB, Canada;Montreal Heart Institute, 5000, Bélanger Street, Montréal H1T 1C8 Québec, Canada;St. Michael’s Hospital, 30 Bond Street, Toronto M5B 1W8, ON, Canada;St. Paul’s Hospital, 1081 Burrard Street, Vancouver V6Z 1Y6, BC, Canada;General Division, Hamilton Health Sciences, 237 Barton Street East, Hamilton L8L, 2X2, ON, Canada;University of Toronto, Toronto M5T 1P8 ON, Canada;School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa K1H 8M5, ON, Canada;Ottawa Cardiovascular Centre, Bank Street Professional Centre, 502-1355 Bank Street, Ottawa K1H 8K7, Canada

关键词: Study protocol;    Pilot study;    Refractory angina;    Patient decision aid;   

Others  :  814627
DOI  :  10.1186/1477-7525-12-93

 received in 2014-02-03, accepted in 2014-06-06,  发布年份 2014

【 摘 要 】

Background

Refractory angina is a severe chronic disease, defined as angina which cannot be controlled by usual treatments for heart disease. This disease is frightening, debilitating, and difficult to manage. Many people suffering refractory have inadequate pain relief, continually revisit emergency departments for help, undergo repeated cardiac investigations, and struggle with obtaining appropriate care. There is no clear framework to help people understand the risks and benefits of available treatment options in Canada. Some treatments for refractory angina are invasive, while others are not covered by provincial health insurance plans. Effective care for refractory angina sufferers in Canada is critically underdeveloped; it is important that healthcare professionals and refractory angina sufferers alike understand the treatment options and their implications. This proposal builds on the recent Canadian practice guidelines for the management of refractory angina. We propose to develop a decision support tool in order to help people suffering from refractory angina make well-informed decisions about their healthcare and reduce their uncertainty about treatment options.

Methods

This project will be conducted in three phases: a) development of the support tool with input from clinical experts, the Canadian refractory angina guidelines, and people living with refractory angina, b) pilot testing of the usability of the tool, and c) formal preliminary evaluation of the effectiveness of the support tool to help people make informed decisions about treatment options.

Discussion

A decision support tool for refractory angina is needed and the available data suggest that by developing such a tool, we may be able to help refractory angina sufferers better understand their condition and the effectiveness of available treatment options (in their respective clinical settings) as well as their implications (e.g. risks vs. benefits). By virtue of this tool, we may also be able to facilitate identification and inclusion of patients’ values and preferences in the decision making process. This is particularly important as refractory angina is an intractable condition, necessitating that the selected course of treatment be lifelong. This study will yield a much needed patient decision aid for people living with refractory angina and pilot data to support a subsequent effectiveness study.

【 授权许可】

   
2014 McGillion et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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