ArticleMedical decision making : an international journal of the Society for Medical Decision Making2023
Informed Decision Making for Anticoagulation Therapy for Atrial Fibrillation.
Article in Medical decision making : an international journal of the Society for Medical Decision Making, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Patient perspectives on atrial fibrillation management and pharmacist roles in outpatient clinics: a qualitative study.International journal of clinical pharmacy · 2026Article
- Oral anticoagulant prescribing and DOAC dosing appropriateness in patients with non-valvular atrial fibrillation: a retrospective study from Vietnam.BMC cardiovascular disorders · 2026Observational
- Exploring Italian nursing staff in anticoagulation clinics: a cluster-based description of current practice, nurse self-efficacy, job satisfaction, and interprofessional collaboration.Internal and emergency medicine · 2026Article
- Role of primary and secondary care data in atrial fibrillation ascertainment: impact on risk factor associations, patient management, and mortality in UK Biobank.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Patient-healthcare Professional Dialog from the Patient's Perspective: Concept Analysis Based on Literature Review.Journal of patient experience · 2025Article
- Leveraging quality improvement initiatives to support development of decision support tools in healthcare.Health systems (Basingstoke, England) · 2025Article
- Rurality and Atrial Fibrillation: Patient Perceptions of Barriers and Facilitators to Care.Journal of the American Heart Association · 2023Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPatients with atrial fibrillation (AF) must decide between warfarin and direct oral anticoagulants (DOACs), a decision involving important tradeoffs. Our objective was to understand whether physicians engage patients in informed decision making for anticoagulants.
designWe performed an analysis of recorded conversations between physicians and anticoagulation-naïve patients in the Verilogue Point-of-Practice database. We assessed the presence of 7 elements of informed decision making, as well as a discussion of financial costs.
resultsOf 37 encounters with 21 physicians, 92% resulted in a DOAC prescription and 8% resulted in a warfarin prescription. Seventy percent met criteria for discussion of pros and cons, 70% for discussion of the alternatives, 43% presented the decision, 30% included an assessment of patient understanding, 22% included an explanation of the patient's role in decision making, 22% included an assessment of patient preferences, and 19% included a discussion of uncertainty. Two encounters (5%) included all 7 elements and 9 (24%) included none. Physicians discussed treatment costs with patients in 43% of encounters. LIMITATIONS: We assessed informed decision making in a single encounter. Physicians and patients may have had other discussions that were not captured in our data.
conclusionsPhysicians often presented the alternatives but did not generally engage patients in informed decision making. The high rate of DOAC prescriptions is likely the result of physician preferences, as patient preferences were rarely assessed. IMPLICATIONS: Strategies to support physicians in engaging patients in informed decision making for anticoagulation are needed. HIGHLIGHTS: While physicians discussed the alternatives and presented pros and cons with patients, they rarely assessed patient preferences, explained the patient's role in decision making, or addressed uncertainty.The cost of treatment with DOACs versus warfarin was discussed by physicians in less than half of encounters, limiting patients' ability to make informed decisions for anticoagulation.Only 2 encounters (5%) fulfilled all 7 elements of informed decision making.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.