Use of decision aids for shared decision making in venous thromboembolism: A systematic review

- Optimal care of VTE patients integrates patient preferences into decision-making.
- Few studies of decision aids in VTE care have been published.
- More research is needed to develop and test decision aids for VTE care.

BackgroundOptimal care of patients with venous thromboembolism requires the input of patient preferences into clinical decision-making. However, the availability and impact of decision aids to facilitate shared decision making in care of venous thromboembolism is not well known.ObjectivesTo assess the availability, clinical impact and outcomes associated with the use of decision aids in patients with or at risk for venous thromboembolism.Patients/methodsA systematic review of the literature was performed exploring the use of decision aids in patients with venous thromboembolism. Criteria for primary inclusion required use of patient values clarification in the decision aid. A secondary review without the requirement of a patient values clarification was performed to be more inclusive. The data was summarized such that knowledge gaps and opportunities for enquiry were identified.ResultsThe primary review identified one study that explored the decision to extend anticoagulation in patients with a recent venous thromboembolism beyond the stipulated 3-month duration. The secondary review identified an additional study exploring the decision to undergo computer tomography testing in patients at low risk for pulmonary embolism in an emergency department setting. Both studies were of modest quality given a lack of control group for comparison analysis.ConclusionsDespite numerous calls to increase use of shared decision-making, a paucity of data exists to help patients engage in the treatment decisions for venous thromboembolism. Future studies of additional VTE clinical decisions with longer-term clinical outcomes appear necessary.