21 October 2022

Research led by Royal Papworth Hospital clinicians has supported the use of shared decision making in cardiology, leading to more effective and safer care. 

Shared decision making describes the process by which healthcare professionals and patients reach a joint decision about their care.

This patient-centred approach allows patients to take a more active role in decisions about their health, and has been actively promoted for many conditions but recommendations of its use in cardiac clinical guidelines remain varied. 

The meta-analysis, which was a collaboration between Cambridge, Norwich and Southampton, investigated the effectiveness of existing strategies facilitating shared decision making in cardiology. 

Dr Harris Papadopoulou, NIHR Academic Clinical Lecturer in Cardiology at Royal Papworth Hospital and the University of Cambridge, who jointly-led the study, said: “The meta-analysis advocates the use of shared decision-making tools in cardiology.

"It clearly shows that they improve patients’ understanding of treatment options, promotes patient involvement in their care, aids an informed decision process, improves communication between doctors and patients, and improves patient satisfaction.”

The results have been published in Heart, an international journal publishing important research and reviews in cardiovascular disease. 

More than 9,000 research items were screened to identify 159 studies which were then scrutinised by Dr Panagiota Mitropoulou (University Hospital Southampton NHS Foundation Trust) and Dr Nicolai Grüner-Hegge (Royal Papworth Hospital). 

Four people's faces each appearing in a different quadrant.

Clockwise from top left: Dr Reinhold, Dr Papadopoulou, Dr Mitropoulou and Dr Grüner-Hegge

From that, 18 randomised control trials were identified – including more than 4,400 patients – that used various interventions to facilitate shared decision making in cardiology.

“This study was the first systematic review and meta-analysis investigating the effectiveness of shared decision making in cardiology," added joint senior author Dr Johannes Reinhold, Honorary Specialist Registrar at Royal Papworth Hospital, NIHR Academic Clinical Lecturer in Cardiology at Norfolk and Norwich University Hospitals and the University of East Anglia.

“Whether it was printed aids, videos, computer programmes or direct education, this all reduced decisional conflict and suggested that patients were more content with their decisions. 

“Interestingly, the findings were applicable to a wide range of cardiac conditions suggesting that this patient-centred approach could be helpful across the spectrum of cardiology.

“These results are really exciting and show the benefit of shared decision making in cardiology and why it should be used more frequently.

“We are now looking at ways to support this patient-centred approach in the care we provide.”