(P090) DECISION AIDS FOR PATIENTS WITH STABLE CORONARY ARTERY DISEASE: A SYSTEMATIC REVIEW

Background: Patients with stable coronary artery disease (CAD) who undergo an angiogram are faced with challenging decisions regarding their treatment options. Decision aids (DAs) are essential tools in guiding patients through these complex decisions and facilitating their understanding of the risks and benefits associated with each option. This systematic review aims to evaluate web- or paper-based DAs developed to assist patients with stable CAD in making informed decisions regarding medical management, percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG). This review will focus on assessing the impact of these DAs on informed decision-making, patient satisfaction, and bridging knowledge gaps among patients undergoing an angiogram.

METHODS AND RESULTS: A search was conducted across Medline, Embase, Scopus, and CINAHL databases for studies that developed a DA for stable CAD patients considering PCI, CABG, or medical management. Eligible articles, published electronically between 2016 and the present, needed to be full-text, in English, and include clearly defined patient outcomes. Three independent reviewers screened and extracted data. The quality of the DAs was assessed using the Critical Appraisal Skills Programme (CASP) checklist.

716 studies were initially identified, with 30 full-text articles screened through Covidence, leading to the inclusion of 2 articles for the analysis (see appendix A). The first article provided a paper-based DA designed to assist stable CAD patients in making treatment decisions between PCI and medical management. The findings demonstrate statistically significant improvement in patient knowledge concerning PCI and medical management compared to standard care (60% DA; 40% usual care; p=0.034). Additionally, patients reported feeling more informed about their treatment options (p=0.043). The second article developed a web-based DA to assist patients in deciding between PCI, CABG, and medical management. The findings demonstrate improved performance on a 6-item knowledge scale (p < 0.01) and increased interest in shared decision-making.

Conclusion: This systematic review reveals a gap in evaluated DAs for stable CAD patients facing treatment decisions. The first DA focused solely on PCI and medical management, whereas the second DA addressed all three options but was inaccessible online for review. Although both DAs demonstrate improvement in patient knowledge, there is an absence of available DAs tailored to guide decisions for all three treatment modalities. This emphasizes the importance of developing and evaluating a comprehensive tool for stable CAD patients.