Decisional Needs and Patient Treatment Preferences for Heart Failure Medications: Scoping Review Protocol

Abstract

AbstractIntroductionTreatment decisions regarding heart failure with reduced ejection fraction (HFrEF; ejection fraction ≤40%) pharmacotherapy are complex. Decision aids can bridge this knowledge-to-practice gap and improve the integration of patients’ preferences and values for patient-centered care. However, little is known about the preferences and decisional needs of patients regarding these medications. The objectives of this scoping review are to identify, map and synthesize the literature evaluating the decisional needs, treatment preferences and values of patients making decisions regarding HFrEF medications.Methods and AnalysisWe will search MEDLINE, Embase, CINAHL (inception-April 2022), bibliographies of included studies and relevant reviews, Web of Science ‘cited references’, cocites.com, clinicaltrials.gov, Epistemonikos, and the Ottawa Decision Aid Inventory, without language restriction. We will include qualitative, quantitative, and mixed-methods studies that describe patient and clinician decisional needs, or patient treatment preferences or values regarding HFrEF medications guided by the Ottawa Decision Support Framework, or decision aids to support HFrEF medication decisions. One author will perform all searches and upload results to Covidence. Two review authors will independently screen retrieved article titles and abstracts for inclusion, review full-text for final inclusion, and extract data from included articles and decision aids using a standardized data extraction form. We will present a graphical abstract mapping what is known about decisional needs and patient preferences and values, decisional support interventions, and decisional outcomes regarding HFrEF medications. We will also describe extracted data in narrative and tabular format to address the scoping review objectives, and discuss implications for practice and subsequent research in the field of shared decision-making for HFrEF.Ethics and DisseminationResearch ethics board approval is not required for this scoping review of published data. We will present the findings at relevant conferences, publish a peer-reviewed manuscript, and disseminate results via institutional and partner social media platforms.Strengths and limitations of this studyThis scoping review will systematically identify, map and synthesize the decisional needs, treatment preferences and values of patients regarding heart failure medication decisions.We have developed a comprehensive search strategy to identify qualitative, quantitative and mixed-methods studies (published and unpublished), as well as decision aids.The review will follow methodology outlined in the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines.The results of the scoping review will ultimately be limited by available studies; however, preliminary searches have identified several eligible studies.