Shared Decision Making in the Heart Team

This heart team review gives an overview of the current status of SDM in heart teams, and investigates the perceived needs for implementation of a SDM approach in clinical practice through an exploratory cross-sectional survey (N=101) and in-depth interviews (N=9) among an international community of heart team physicians specialized in HVD. Although heart team physicians agree on the importance of involving patients in heart team treatment decisions, half leaned toward the heart team making final decisions. In addition, limited understanding of the concept of SDM poses another barrier for physicians in involving patients in their own clinical practice. Finally, limited knowledge of and experience with the use of evidence-based decision aids is hampering wider implementation of SDM in clinical practice. The perceived needs and requirements for implementation of SDM according to heart team physicians forecast a long and winding road forward to sustainable implementation of SDM in heart teams. However, directly addressing attitudes, skills and tools may pave the way to effective implementation of SDM in heart teams. In conclusion, SDM is a means to improve care delivery for patients with HVD. Barriers exist for successful implementation by heart teams, yet opportunities arise as the culture shifts to physicians supporting patient engagement in decision making.

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