The Impact of Patient Involvement in Decision-Making About Heart Disease Prevention

Decision Aid to Improve Coronary Heart Disease Risk Modification: a Pilot Randomized Trial

The purpose of this study is to determine whether providing patients with information about their global coronary heart disease (CHD) risk and effective risk-reducing strategies allows them to make appropriate decisions about heart disease prevention.

Background: Low utilization of effective CHD prevention strategies may be due to many factors, but chief among them is the lack of patient involvement in prevention decisions. We undertook this study to test the effectiveness of an individually-tailored, computerized decision aid about CHD on patients' discussions with their doctor and their plans for CHD prevention.

Methods: We conducted a pilot randomized trial in a convenience sample of adults with no previous history of cardiovascular disease to test the effectiveness of an individually-tailored, computerized decision aid about CHD prevention against a risk factor list that patients could present to their doctor.

Inclusion Criteria:

• presenting for routine medical care with regular medical provider
• able to understand, speak, and read English

Exclusion Criteria:

• prior history of cardiovascular disease
• history of serious medical illness that would limit candidacy for screening
• previous participation in intensive risk modification as part of diabetes study in our clinic
• no cholesterol measurement in the last 3 years, limiting ability to provide up-to-date risk estimate