"What Is the Right Decision for Me?" Integrating Patient Perspectives Through Shared Decision-Making for Valvular Heart Disease Therapy

Can J Cardiol. 2021 Jul;37(7):1054-1063. doi: 10.1016/j.cjca.2021.02.022. Epub 2021 Mar 9.


Innovations in the treatment of valvular heart disease have transformed treatment options for people with valvular heart disease. In this rapidly evolving environment, the integration of patients' perspectives is essential to close the potential gap between what can be done and what patients want. Shared decision-making (SDM) and the measurement of patient-reported outcomes (PROs) are two strategies that are in keeping with this aim and gaining significant momentum in clinical practice, research, and health policy. SDM is a process that involves an individualised, intentional, and bidirectional exchange among patients, family, and health care providers that integrates patients' preferences, values, and priorities to reach a high-quality consensus treatment decision. SDM is widely endorsed by international valvular heart disease guidelines and increasingly integrated in health policy. Patient decision aids are evidence-based tools that facilitate SDM. The measurement of PROs-an umbrella term that refers to the standardised reporting of symptoms, health status, and other domains of health-related quality of life-provides unique data that come directly from patients to inform clinical practice and augment the reporting of quality of care. Sensitive and validated instruments are available to capture generic, dimensional, and disease-specific PROs in patients with valvular heart disease. The integration of PROs in clinical care presents significant opportunities to help guide treatment decision and monitor health status. The integration of patients' perspectives promotes the shift to patient-centred care and optimal outcomes, and contributes to transforming the way we care for patients with valvular heart disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Decision Making, Shared*
  • Heart Valve Diseases* / psychology
  • Heart Valve Diseases* / therapy
  • Humans
  • Patient Care Management* / methods
  • Patient Care Management* / standards
  • Patient Care Management* / trends
  • Patient Preference
  • Patient Reported Outcome Measures
  • Quality of Life*
  • Risk Adjustment