PCORI implementation projects promote the use of findings from PCORI-funded studies. The initiative on Implementation of Effective Shared Decision Making Approaches in Practice Settings funds projects like this one to promote the use of shared decision making strategies tested in PCORI-funded studies or incorporating evidence from PCORI-funded research, to support patients in making informed decisions about their care.
This project focuses on implementing findings from the completed PCORI-funded research project: Supporting Shared Decision Making for Patients with Heart Failure Offered a Left Ventricular Assist Device -- The DECIDE-LVAD Trial
COVID-19-Related Project Enhancement
Family caregivers help care for patients with an LVAD at home. During COVID-19, caregivers have become more important. As health systems switch from in-person to telehealth care, caregivers take patients’ vital signs, manage patients’ medicines, and check for signs of worsening disease. At the same time, caregivers may feel isolated due to social distancing.
With this enhancement, the project team wants to support caregiver well-being during COVID-19. The team will add two ways to support caregivers to the LVAD shared decision- making program. One way will be support from a trained coach via telehealth. The other way will be a web-based support group. The project team will share findings with all LVAD centers.
Enhancement Award Amount: $499,996
This project is in progress.
What were the results from the original PCORI-funded research study?
The original study looked at shared decision making for patients thinking about getting a left ventricular assist device, or LVAD, as a treatment for advanced heart failure. Shared decision making is a process in which patients work with their doctors to select tests and treatments based on what is most important to them. The shared decision making approach included printed materials and video guides for patients and training for doctors and staff in working with patients and caregivers to use these materials.
The study found that patients in the shared decision making program in six LVAD centers knew more about LVADs and were more likely to get treatment that matched their goals than patients receiving usual LVAD education.
Why is this research finding important?
LVADs can help people with advanced heart failure stay alive longer. But LVADs have serious risks, like stroke, bleeding, and infection. In addition, people who get LVADs need the help of a caregiver and must make changes to their lifestyle. Shared decision making can help patients understand the trade-offs and make the best decision for themselves.
What is the goal of this project?
The project goal is to expand the LVAD shared decision making program to all LVAD centers in the United States.
What is the project team doing?
Working with several cardiology-focused professional societies, the project team is surveying hospitals that offer LVADs to see how ready they are to make shared decision making part of regular care. Based on the results, the team is preparing a strategy specific to the needs of each LVAD center. The strategy can include providing free patient materials, user manuals, and different types of training and support for staff.
How is the team evaluating this project?
The project team is following up with the LVAD centers to see whether they are using the shared decision making program, including how many patients have received materials and how many clinicians have used them with their patients. The team is also surveying patients at several LVAD centers to understand whether the program helped them make a decision and how they feel about their decision.
How is the team involving patients and others in making sure the findings reach people who can use them?
Patients and caregivers who have considered LVADs and doctors and hospital staff who work in LVAD programs are helping to create the materials and work with LVAD centers. They are also involved in longer-term planning for shared decision making around LVADs.
Learn more about PCORI’s Dissemination and Implementation program here.
Related PCORI-funded Research Project
Note: Results from the original project have completed PCORI’s Peer Review and are available here.
Implementation of Effective Shared Decision Making Approaches in Practice Settings