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PP05.004 Shared decision-making and advance care planning in patients with aortic stenosis: patient evaluation of an integrative decision aid
  1. Ana Rosca1,
  2. Ulrike Ehlers2,
  3. Isabelle Karzig3,
  4. Frank Scherff4 and
  5. Tanja Krones1
  1. 1Triemli Hospital, Clinical Ethics, Zurich, Switzerland
  2. 2Surgical Intensive Care Unit, Cantonal Hospital St Gallen,, St Gallen, Switzerland
  3. 3University Hospital/University of Zurich, Clinical Ethics and Institute of Biomedical Ethics and History of Medicine, Zurich, Switzerland
  4. 4Cardiology Unit, University Hospital Zurich, Zurich, Switzerland


Background Shared decision making (SDM) and advance care planning (ACP) are two patient-centered concepts that support patients, their relatives and healthcare professionals engage in a decision-making process in which patient autonomy is best put into practice. Combining the two complex interventions into one process may support patients with moderate and high treatment complication risks make better-informed choices. We therefore developed a novel integrative decision aid to support patients with aortic stenosis make better informed medical choices regarding their immediate and future care. The aim of this study is to assess the quality of the decision aid by patients.

Methods In this study, we included all patients that underwent a transcatheter aortic valve implantation (TAVI) intervention between January and September 2022 who agreed to a semi-structured telephone interview.

Results Of 130 patients that underwent TAVI, only eight agreed to participate in the study. They all assessed the decision aid positively with respect to layout, use of language and comprehension. Most participants assessed the use of statistical risk comparison of the three main treatment options (TAVI, surgical aortic valve replacement or palliative care) as ‘too open’ and ‘brutally direct’.

We also collected the feedback of eleven patients that refused to participate in the study. They stated poor comprehension and length of the decision aid (32 pages) as reason for non-participation.

Conclusion For higher acceptability of decision aids for TAVI patients, a better contextualization and explanation of data on risk and complications and addressing loved ones in the decision aid besides patients is necessary. Shortening the length of the decision aid might also improve the acceptability and use of the decision aid by patients themselves.

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