Skip to main content
Journal cover image

Decision Aid Implementation among Left Ventricular Assist Device Programs Participating in the DECIDE-LVAD Stepped-Wedge Trial.

Publication ,  Journal Article
Matlock, DD; McIlvennan, CK; Thompson, JS; Morris, MA; Venechuk, G; Dunlay, SM; LaRue, SJ; Lewis, EF; Patel, CB; Blue, L; Chaussee, EL ...
Published in: Med Decis Making
April 2020

Background. Despite demonstrated efficacy, patient decision aids (DAs) are rarely used in clinical practice in the absence of coverage mandates. Deciding whether to pursue a left ventricular assist device (LVAD) is a major, preference-sensitive decision-ideal for exploring implementation of a DA. Methods. We conducted a type II effectiveness-implementation hybrid trial at 6 LVAD programs using a stepped-wedge cluster-randomized design. Using the RE-AIM framework, we collected both quantitative and qualitative outcomes, including a checklist collected by study staff for each enrolled patient regarding DA use and interviews with LVAD program clinicians preintervention, 6 months postintervention, and at the conclusion of the study. Results. From June 2015 to January 2017, 248 patients and their caregivers were enrolled. A total of 69 interviews were conducted with 48 clinicians at 3 time points. The DA reached 95% of eligible patients. Adoption was 100%, as all sites approached agreed to participate in the trial. Interviews revealed several themes related to the implementation of the DA: clinicians had a strong desire to ensure patients were informed and embraced the DA. Despite this, they reported communication challenges among their team that impeded implementation. Five of the 6 sites have maintained use of the DA following the trial; 1 site reported concerns about decreased procedural volume with use of the DA as a reason for discontinuation. Conclusions. In this hybrid trial, a DA for patients considering LVADs and their caregivers demonstrated high reach. Adoption and implementation were facilitated by a strong desire to ensure that patients were well informed. Future dissemination research and practice should attend to concerns about procedure volume and coverage mandates and facilitate ongoing communication at sites using the DA.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Med Decis Making

DOI

EISSN

1552-681X

Publication Date

April 2020

Volume

40

Issue

3

Start / End Page

289 / 301

Location

United States

Related Subject Headings

  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Heart Ventricles
  • Heart Failure
  • Health Policy & Services
  • Health Knowledge, Attitudes, Practice
  • Female
  • Decision Support Techniques
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Matlock, D. D., McIlvennan, C. K., Thompson, J. S., Morris, M. A., Venechuk, G., Dunlay, S. M., … Allen, L. A. (2020). Decision Aid Implementation among Left Ventricular Assist Device Programs Participating in the DECIDE-LVAD Stepped-Wedge Trial. Med Decis Making, 40(3), 289–301. https://doi.org/10.1177/0272989X20915227
Matlock, Daniel D., Colleen K. McIlvennan, Jocelyn S. Thompson, Megan A. Morris, Grace Venechuk, Shannon M. Dunlay, Shane J. LaRue, et al. “Decision Aid Implementation among Left Ventricular Assist Device Programs Participating in the DECIDE-LVAD Stepped-Wedge Trial.Med Decis Making 40, no. 3 (April 2020): 289–301. https://doi.org/10.1177/0272989X20915227.
Matlock DD, McIlvennan CK, Thompson JS, Morris MA, Venechuk G, Dunlay SM, et al. Decision Aid Implementation among Left Ventricular Assist Device Programs Participating in the DECIDE-LVAD Stepped-Wedge Trial. Med Decis Making. 2020 Apr;40(3):289–301.
Matlock, Daniel D., et al. “Decision Aid Implementation among Left Ventricular Assist Device Programs Participating in the DECIDE-LVAD Stepped-Wedge Trial.Med Decis Making, vol. 40, no. 3, Apr. 2020, pp. 289–301. Pubmed, doi:10.1177/0272989X20915227.
Matlock DD, McIlvennan CK, Thompson JS, Morris MA, Venechuk G, Dunlay SM, LaRue SJ, Lewis EF, Patel CB, Blue L, Chaussee EL, Glasgow RE, Walsh MN, Allen LA. Decision Aid Implementation among Left Ventricular Assist Device Programs Participating in the DECIDE-LVAD Stepped-Wedge Trial. Med Decis Making. 2020 Apr;40(3):289–301.
Journal cover image

Published In

Med Decis Making

DOI

EISSN

1552-681X

Publication Date

April 2020

Volume

40

Issue

3

Start / End Page

289 / 301

Location

United States

Related Subject Headings

  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Heart Ventricles
  • Heart Failure
  • Health Policy & Services
  • Health Knowledge, Attitudes, Practice
  • Female
  • Decision Support Techniques