JACC: Advances Expert Panel Perspective: Shared Decision-Making in Multidisciplinary Team-Based Cardiovascular Care

Elizabeth M Perpetua; Roseanne Palmer; Viet T Le; Sana M Al-Khatib; Craig J Beavers; Joshua A Beckman; Biykem Bozkurt; Megan Coylewright; Caroline Lloyd Doherty; Kimberly A Guibone; Marian Hawkey; Patricia A Keegan; James N Kirkpatrick; Jessica Laperle; Sandra B Lauck; Glenn Levine; Brian R Lindman; Michael J Mack; Andrea L Price; Susan Strong; Janet F Wyman; Quentin R Youmans; Martha Gulati

doi:10.1016/j.jacadv.2024.100981

JACC: Advances Expert Panel Perspective: Shared Decision-Making in Multidisciplinary Team-Based Cardiovascular Care

JACC Adv. 2024 Jul 3;3(7):100981. doi: 10.1016/j.jacadv.2024.100981. eCollection 2024 Jul.

Authors

Elizabeth M Perpetua^{1

2}, Roseanne Palmer³, Viet T Le⁴, Sana M Al-Khatib⁵, Craig J Beavers⁶, Joshua A Beckman⁷, Biykem Bozkurt⁸, Megan Coylewright⁹, Caroline Lloyd Doherty¹⁰, Kimberly A Guibone¹¹, Marian Hawkey¹², Patricia A Keegan¹³, James N Kirkpatrick^{14

15}, Jessica Laperle³, Sandra B Lauck¹⁶, Glenn Levine⁸, Brian R Lindman¹⁷, Michael J Mack¹⁸, Andrea L Price¹⁹, Susan Strong²⁰, Janet F Wyman²¹, Quentin R Youmans²², Martha Gulati²³

Affiliations

¹ Empath Health Services, Seattle, Washington, USA.
² School of Nursing, Department of Biobehavioral Nursing and Informatics, University of Washington, Seattle, Washington, USA.
³ Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
⁴ Intermountain Health, Salt Lake City, Utah, USA.
⁵ Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
⁶ University of Kentucky College of Pharmacy, Lexington, Kentucky, USA.
⁷ Southwestern Medical Center, University of Texas, Dallas, Texas, USA.
⁸ Baylor College of Medicine, Houston, Texas, USA.
⁹ Erlanger Health System, Chattanooga, Tennessee, USA.
¹⁰ School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
¹¹ Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
¹² Hackensack University Medical Center, Heart and Vascular Hospital, Hackensack, New Jersey, USA.
¹³ Columbia University Irving Medical Center, Center of Interventional Therapy, New York, New York, USA.
¹⁴ Emory Healthcare, Heart and Vascular, Atlanta, Georgia, USA.
¹⁵ Departments of Medicine and Bioethics and Humanities, Division of Cardiology, University of Washington, Seattle, Washington, USA.
¹⁶ University of British Columbia, Vancouver, British Columbia, Canada.
¹⁷ Vanderbilt University Medical Center, Division of Cardiovascular Medicine, Nashville, Tennessee, USA.
¹⁸ Baylor Scott and White Health, Dallas, Texas, USA.
¹⁹ Indiana University Health, Indianapolis, Indiana, USA.
²⁰ Heart Valve Voice US, Washington DC, USA.
²¹ Department of Structural Heart, Division of Cardiovascular Medicine, Henry Ford health System, Detroit, Michigan, USA.
²² Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
²³ Preventive Cardiology, Barbra Streisand Women's Heart Center, Preventive and Cardiac Rehabilitation Center, Women's Cardiovascular Medicine & Research, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, California, USA.

Abstract

Shared decision-making (SDM) and multidisciplinary team-based care delivery are recommended across several cardiology clinical practice guidelines. However, evidence for benefit and guidance on implementation are limited. Informed consent, the use of patient decision aids, or the documentation of these elements for governmental or societal agencies may be conflated as SDM. SDM is a bidirectional exchange between experts: patients are the experts on their goals, values, and preferences, and clinicians provide their expertise on clinical factors. In this Expert Panel perspective, we review the current state of SDM in team-based cardiovascular care and propose best practice recommendations for multidisciplinary team implementation of SDM.

Keywords: atherosclerotic cardiovascular disease; cardiac imaging; cardiovascular disease; chest pain; electrophysiology; heart failure; interventional cardiology; prevention; shared decision-making; structural heart; valvular heart disease.

Publication types

Review