Impact of shared decision-making in patients with atrial fibrillation eligible for novel oral anticoagulant therapy

Abstract Shared decision-making (SDM) promotes greater patient awareness about medical conditions and treatments, and facilitates patient involvement in care decisions. This two-stage multicenter study evaluated the impact of SDM in Taiwanese adults with atrial fibrillation (AF) eligible for novel oral anticoagulant (NOAC) therapy. Participants were NOAC-naïve (case) or dabigatran-experienced (control). During Stage I, case participants (n = 124) completed a semi-structured survey before and after viewing SDM materials on stroke prevention for AF. The surveys collected data on anxiety about AF, confidence in healthcare professionals, usefulness of SDM materials, and perception of different NOACs. During Stage II, both case participants (n = 87) and control participants (n = 104) completed another survey. Fewer case participants were anxious about AF (p < 0.01), and more had confidence in healthcare professionals (p < 0.01) after viewing the SDM materials than before. Most case participants (≥ 90%) rated the SDM materials “very helpful”. Dabigatran was the NOAC of choice after viewing the SDM materials among 90% of case participants. In Stage II, participants viewing SDM before initiating dabigatran had lower anxiety (case, 43%; control, 53%; p < 0.01) and a higher level of trust (case, 92%; control, 84%; p < 0.01). In conclusion, SDM reduced anxiety and improved trust in healthcare professionals among NOAC-naïve participants with AF.