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This presentation explores Shared Decision-Making in LVAD Therapy, discussing the benefits and risks to help patients make informed choices. It includes a detailed explanation of the medically reasonable options, the Decision-Making Process, and Decision Support Tools such as patient aids. The content highlights the importance of considering patient preferences and values in treatment decisions. Future directions and potential questions regarding the ideal timing, indication relevance, and new technologies are also discussed.
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Decision Tree Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine Section of Advanced Heart Failure and Transplantation INTERMACS 2016
Disclosures • None.
Outline • What is Shared Decision Making? • LVAD Therapy (DT) • Decision Support Tools
Classes of Treatment Decisions Benefit When scientific evidence for benefit strongly outweighs harm, behavioral support (e.g. smoking cessation, beta-blocker) designed to describe, justify, and recommend is most appropriate. Risk
Classes of Treatment Decisions Benefit LVAD 32F peri-partum CM INTERMACS 2 Risk
Classes of Treatment Decisions Shared decision makingis most easily applied to preference-sensitive decisions, to help patients think through, forecast, and deliberate their options. Benefit Risk
Classes of Treatment Decisions LVAD 75M multi-morbidity INTERMACS 5 Benefit Risk
McIlvennan, Magid, Ambardekar, Thompson, Matlock, Allen. Circ Heart Fail. 2015
Dichotomy in Approach McIlvennan et al. Circ Cardiovasc Qual Outcomes. 2014
Dichotomy in Approach McIlvennan et al. Circ Cardiovasc Qual Outcomes. 2014
Explain and define the medically reasonable options Shared Decision-Making Process describe the risks, benefits, burdens of each option solicitation of patient preferences, values, goals
Decision Aids www.patientdecisionaid.org
Thompson, Matlock, McIlvennan, Jenkins, Allen. JACC Heart Fail. 2015
Thompson, Matlock, McIlvennan, Jenkins, Allen. JACC Heart Fail. 2015
Future Directions • Ideal timing? • Does indication matter? • New technology
Questions? colleen.mcilvennan@ucdenver.edu