Center for Medical Ethics and Health Policy

Dissemination and Implementation of a Patient-Centered Decision Aid for Left Ventricular Assist Device Placement

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Project Description

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Under the direction of Jennifer Blumenthal-Barby, Ph.D, this funding award by the Patient-Centered Outcomes Research Institute will enable Baylor College of Medicine to collaborate with nine U.S. hospitals to implement a patient-centered decision aid for patients considering left ventricular assist device (LVAD) placement as the standard of care for patient education.

The decision aid was developed and tested by investigators at Baylor College of Medicine. In a multi-site randomized controlled trial, patients receiving the decision aid had higher knowledge, ability to envision life with LVAD, and satisfaction with life post-LVAD compared to patients receiving standard education. The Baylor College of Medicine team will help build capacity among clinicians to use the decision aid with patient in routine cardiology care and will track dissemination and implementation outcomes including the proportion of eligible patients that receive the decision aid at each hospital and the degree of fidelity and shared decision making during decision aid administration.

Partner hospitals include Houston Methodist Hospital, Texas Heart Institute at Baylor St. Luke’s Medical Center, Cleveland Clinic, Brigham and Women’s Hospital, Montefiore Medical Center, Miami Transplant Institute, Aurora St. Luke’s Healthcare, INTEGRIS Baptist Medical Center.

Supported by: Patient-Centered Outcomes Research Institute

Project Personnel

Principal Investigator
Jennifer Blumenthal-Barby, Ph.D., Principal Investigator

Co-Investigators
Kristin Kostick, Ph.D., Staff Scientist

Project Personnel
Robert Volk, Ph.D., Consultant
Jerry Estep, M.D., Clinical Lead

Center Project Personnel
Lauren Schoen, Research Coordinator

Publications

Kostick, K. M., Trejo, M., Volk, R. J., Estep, J. D., & Blumenthal-Barby, J. S. (2020). Using Nudges to Enhance Clinicians’ Implementation of Shared Decision Making with Patient Decision Aids. MDM Policy & Practice, 5(1), 2381468320915906.

Buchberg Trejo, M., Kostick, K. M., Estep, J. D., & Blumenthal-Barby, J. S. (2019). Identifying knowledge gaps among LVAD candidates. Journal of Clinical Medicine, 8(4), 549.

Kostick, K., Trejo, M., & Blumenthal-Barby, J. S. (2019). Suffering and Healing in the Context of LVAD Treatment. Journal of Clinical Medicine, 8(5), 660.

Blumenthal-Barby J.S., Kostick K.M., Trejo M., Bhimaraj A., Civitello A., Horstmanshof D.A., Jorde U.P., Loebe M., Mehra M.R., Thohan V, Trachtenberg B.H., Uriel N., Volk R.J., Estep J.D. (2020). Implementation of Patient-Centered Shared Decision Making for LVAD Candidates: Year 1 Results of a Multi-Site Study. J Heart Lung Transplant, 39(4): S159. https://doi.org/10.1016/j.healun.2020.01.1105

Kostick, K.M., Trejo, M., Bhimaraj, A., Civitello A., Grinstein, J., Horstmanshof D., Jorde U.P., Loebe M., Mehra M.R., Sulemanjee N.Z., Thohan V., Trachtenberg B.H., Uriel N., Volk R.J., Estep J.D., Blumenthal-Barby J.S. (2021). A Principal Components Analysis of Factors Associated with Successful Implementation of an LVAD Decision Support Tool. BMC Medical Informatics and Decision Making 21, 106. https://doi.org/10.1186/s12911-021-01468-z.

Kostick KM, Trejo M, Volk RJ, Estep JD, Blumenthal-Barby JS. Using Nudges to Enhance Clinicians' Implementation of Shared Decision Making With Patient Decision Aids. MDM Policy Pract. 2020 Apr  26;5(1):2381468320915906. doi: 10.1177/2381468320915906. PMID: 32440570; PMCID: PMC7227151.

Presentations

Blumenthal-Barby JS, Opel DJ, Dickert NW, Kramer DB, Tucker Edmonds B, Ladin K, Peek M, Peppercorn J, Tilburt JC. Potential Unintended Consequences of Recent Shared Decision Making Policy Initiatives. 

Blumenthal-Barby J.S., Kostick K.M., Trejo M., Bhimaraj A., Civitello A., Horstmanshof D.A., Jorde U.P., Loebe M., Mehra M.R., Thohan V., Trachtenberg B.H.., Uriel N, Volk R.J., Estep J.D. (Submitted). Shared Decision Making in Cardiology Practice: 15 Month Results of a Multi-Site Study of Decision Aid Implementation. Submitted to Heart Failure Society of America Meeting, Cleveland, OH.

Trejo, M. Kostick, K., Blumenthal-Barby, J.S. (May 2020). Shared Decision Making and Behavioral Economics in Cardiology Practice: 15 Month Results of a Multi-Site Study of Decision Aid Implementation. Poster presentation at Baylor College of Medicine Health and Science Policy Day, virtual.

Blumenthal-Barby J.S., Kostick K.M., Trejo M., Bhimaraj A., Civitello A., Horstmanshof D.A.., Jorde U.P., Loebe M., Mehra M.R., Thohan V., Trachtenberg B.H., Uriel N., Volk R.J,. Estep J.D. (2020). Implementation of Patient-Centered Shared Decision Making for LVAD Candidates: Year 1 Results of a Multi-Site Study. Oral presentation accepted for the International Society of Heart and Lung Transplantation Meeting (meeting canceled due to COVID-19).

Trejo, M., Kostick, K. M., Blumenthal-Barby, J. S. (October 2019). “Informed Enough? Assessing LVAD Candidate Knowledge during the Informed Consent Process,” Oral presentation at American Society for Bioethics and Humanities Meeting, Pittsburgh, PA.

Trejo, M., Kostick, K. M., Estep, J. D., Volk, R.J., Blumenthal-Barby, J. S. (September 2019). “Dissemination and Implementation of a Patient-Centered Decision Aid for Ventricular Assist Device Placement: First Quarter Findings,” Poster presentation at PCORI Annual Meeting, Washington DC.

Blumenthal-Barby, J.S., Trejo, M., Kostick, K.M., Volk, R.J., Estep, J.D. (July 2019). “Implementation of Patient-Centered Shared Decision Making in Advanced Heart Failure: A Multi-Site Study,” Poster presentation at International Shared Decision Making Society Conference, Quebec City, Canada.

Blumenthal-Barby, J.S. (March 2019). “Engaging LVAD Patients in the Development, Testing and Implementation of a LVAD Decision Aid,” Oral presentation at American Heart Association's Council on Epidemiology and Prevention Scientific Sessions, Houston, TX.

Blumenthal-Barby, J.S. (March 2019). “Using Decision Aids to Promote Shared Decision-Making during Education and Consent of LVAD Candidates,” Oral presentation at Houston Cardiology Journal Club, Houston, TX.

Trejo, M., Kostick, K. M., Estep, J. D., Volk, R.J., Blumenthal-Barby, J. S. (October 2018). “Dissemination and Implementation of a Patient-Centered Decision Aid for Ventricular Assist Device Placement,” Poster presentation at PCORI Annual Meeting, Washington DC.