ArticleHealth expectations : an international journal of public participation in health care and health policy2013
Patients' decision making to accept or decline an implantable cardioverter defibrillator for primary prevention of sudden cardiac death.
Article in Health expectations : an international journal of public participation in health care and health policy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed.
- The Dutch Implantable Cardioverter-Defibrillator Decision Aid in Clinical Practice: A Stepped-Wedge Randomized Controlled Trial.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Trial
- Facilitating Shared Decision Making Among Black Patients at Risk for Sudden Cardiac Arrest : A Randomized Clinical Trial.Annals of internal medicine · 2023Trial
- Trial
- Article
- Patient Information Needs and Decision-Making Before a Cardiac Implantable Electronic Device: A Qualitative Study Utilizing Social Media Data.Journal of clinical psychology in medical settings · 2025Article
- Article
- Article
- Patients' knowledge and concerns about using the implantable cardioverter defibrillator for the primary prevention of sudden cardiac death and its correlates: A cross-sectional study.Health science reports · 2022Article
- Primary care heart failure service identifies a missed cohort of heart failure patients with reduced ejection fraction.European heart journal · 2022Article
- The development of a decision aid for shared decision making in the Dutch implantable cardioverter defibrillator patient population: A novel approach to patient education.Frontiers in cardiovascular medicine · 2022Article
- Psychological Issues in Managing Families with Inherited Cardiovascular Diseases.Cold Spring Harbor perspectives in medicine · 2020Review
- Validity Evidence of the Brazilian Version of the Florida Shock Anxiety Scale for Patients with Implantable Cardioverter Defibrillators.Arquivos brasileiros de cardiologia · 2020Article
- "I don't know exactly what you're referring to": the challenge of values elicitation in decision making for implantable cardioverter-defibrillators.Patient preference and adherence · 2018Article
- Evaluating the feasibility of conducting a trial using a patient decision aid in implantable cardioverter defibrillator candidates: a randomized controlled feasibility trial.Pilot and feasibility studies · 2017Article
- Clinician time used for decision making: a best case workflow study using cardiovascular risk assessments and Ask Mayo Expert algorithmic care process models.BMC medical informatics and decision making · 2016Article
- "It's not broke, so let's not try to fix it": why patients decline a cardiovascular implantable electronic device.Pacing and clinical electrophysiology : PACE · 2014Article
- Making decisions about implantable cardioverter-defibrillators from implantation to end of life: an integrative review of patients' perspectives.The patient · 2014Review
- Health expectations. Editorial.Health expectations : an international journal of public participation in health care and health policy · 2013Article
- Readability and content of patient education material related to implantable cardioverter defibrillators.The Journal of cardiovascular nursingArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundPatients are offered implantable defibrillators (ICDs) for the prevention of sudden cardiac death (SCD). However, patients' decision-making process (DMP) of whether or not to accept an ICD has not been explored. We asked patients about their decision making when offered an ICD. DESIGN/
settingA grounded theory methodology was employed. Patients were recruited from three ICD centres. Those who received an ICD underwent interviews the first month after implant. Declining patients had interviews at their convenience. In-depth analysis of transcripts was completed. Identified themes were placed along process pathways in a DMP model and tested.
findingsForty-four patients consented to participate (25% women). Thirty-four accepted an ICD and 10 (23%) declined. Ages ranged from 26 to 87 (mean = 65; SD = 12.5). Participants were retired (65%), had ischaemic heart disease (64%) and some post-secondary education (52%). The DMP was triggered when patient's risk for SCD was communicated. The physician's recommendation and a new awareness SCD risk were motivators to accept the ICD. Patient's decision-making approaches fell along a continuum, from active and engaged to passive and indifferent. Patient's approaches were influenced most by the following: (i) trust; (ii) social influences and (iii) health state.
conclusionsHealth-care providers need to recognize the DMP pathways in which ICD candidacy and SCD risk are understood. The factors that influence a patient's decision warrant discussion pre-implant. It is imperative that patients comprehend the meaning of ICD candidacy to make an informed decision. Participants did not recall alternatives to receiving ICD therapy.
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