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'Hmm, Maybe I Don't Want an LVAD'


​Individuals with end-stage heart failure were less likely to opt for left ventricular assist device (LVAD) as destination therapy when they and their physicians were part of a shared decision-making intervention, the DECIDE-LVAD trial suggested.

Patient knowledge of LVADs improved to a greater extent when they received materials describing its risks and benefits and physicians and an education intervention as well, scoring 59.1% on a test before and 70.0% on the same test after the changes, while smaller gains were made among controls at hospitals providing standard clinician and patient education (from 59.5% to 64.9%, P=0.03).

One month after hospitals started the intervention, their patients valued aggressive care to maximize survival less than controls (P=0.03) and favored LVAD therapy less as well (P<0.001), Larry Allen, MD, MHS, of University of Colorado School of Medicine in Aurora, and colleagues, reported online in JAMA Internal Medicine.

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