The impact of government-mandated shared decision-making for implantable defibrillators: A natural experiment.

ABSTRACT:

Background

In 2018, the Centers for Medicare and Medicaid Services (CMS) mandated that patients considering implantation of an implantable cardioverter-defibrillator (ICD) for primary prevention of sudden cardiac death undergo shared decision-making (SDM) using a decision-aid.

Objective

To observe the impact of the CMS's mandate on core measures of SDM using a natural experiment.

Research design, subjects, and measures

Patients who underwent implantation of a primary prevention ICD within the Emory Healthcare system between 2017-2019 (pre and post SDM mandate) were surveyed. Survey domains included knowledge about the ICD, decisional conflict, values-choice concordance, and engagement in decision-making. Patients who had an ICD implant after the mandate were also aske

SUBMITTER: Rao BR 

PROVIDER: S-EPMC8837710 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature