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187 Needs and possibilities for shared decision making within two major heart centers in the Netherlands
  1. Tom Oirbans1,
  2. Mirjam M Garvelink1,2,
  3. Lea M Dijksman1,
  4. Paul van der Nat1,2,
  5. Dennis Van Veghel3,
  6. Daniela N Schultz3,
  7. Marcel GW Dijkgraaf4,
  8. Lucas VA Boersma5
  1. 1Department of Value Improvement, St Antonius hospital, Nieuwegein, the Netherlands
  2. 2IQHealthcare, RadboudUMC, Nijmegen, the Netherlands
  3. 3Department of cardiology and cardiothoracic surgery, Catharina Hospital, Eindhoven, the Netherlands
  4. 4Department of epidemiology and data science, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
  5. 5Department of cardiology, St Antonius hospital, Nieuwegein, the Netherlands


Introduction It has been difficult to implement Shared Decision-Making (SDM) in routine practice for patients with cardiovascular disease (CVD) in the Netherlands. In CVD care, the multidisciplinary heart team plays an important role in determination of treatment options for patients. We aimed to determine attitudes, behaviors, intentions and needs toward SDM in the context of CVD and with special focus on the role of the heart team.

Methods Cross-sectional survey based on the theory of planned behavior, and reformulated versions of the control preferences scale and a SDM questionnaire for health care providers (HCP; SDMQdoc). Respondents were HCPs within two tertiary cardiac Centers in the Netherlands. Data was collected between March and July 2022. Descriptive statistics were used for quantitative data, open-ended questions were thematically analyzed by two independent researchers.

Results 72 HCPs completed the survey. The self-reported knowledge and attitude towards SDM was positive (90% supported SDM), and the benefits of performing SDM in practice were acknowledged by 80%. Participants indicated that they use (several) elements of SDM in daily practice (SDMQDoc score = 73/100), but at the same time, 67% indicates that more SDM can be performed. In self-reported definitions of SDM, the SDM steps of explaining the pros and cons of treatment (step 2) and discussing patients’ preferences (step 3) were most frequently mentioned. Although the heart team was seen as a potential facilitator for SDM, its current role and way of working were mostly reported as a barrier for SDM.

Discussion/Conclusion(s) Physicians reported high knowledge of both the concept and application of SDM, but also reported overlooking some steps in the SDM process. Specific improvements were identified to improve SDM for patients that are discussed in the multidisciplinary heart team, that could be generalized to other multidisciplinary settings.

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