000			04189nam a22005057a 4500
008			240723s20242024 xxu||||| |||| 00| 0 eng d
022			_a2574-3805
024			_a2816743 [pii]
024			_aPMC10966415 [pmc]
040			_aOvid MEDLINE(R)
099			_a38530311
245			_aShared Decision-Making in Cardiovascular Risk Factor Management: A Systematic Review and Meta-Analysis.
251			_aJAMA Network Open. 7(3):e243779, 2024 Mar 04.
252			_aJAMA netw. open. 7(3):e243779, 2024 Mar 04.
253			_aJAMA network open
260			_c2024
260			_p2024 Mar 04
260			_fFY2024
265			_sepublish
265			_tMEDLINE
520			_aConclusions and Relevance: In this systematic review and meta-analysis of the current state of research on SDM interventions for cardiovascular risk management, there was a slight reduction in decisional conflict and an improvement in HbA1c levels with substantial heterogeneity. High-quality studies are needed to inform the use of SDM to improve cardiovascular risk management.
520			_aData Extraction and Synthesis: The systematic search resulted in 9365 references. Duplicates were removed, and 2 independent reviewers screened the trials (title, abstract, and full text) and extracted data. Data were pooled using a random-effects model. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline.
520			_aData Sources: For this systematic review and meta-analysis, a literature search was conducted in the Medline, CINAHL, Embase, Cochrane, Web of Science, Scopus, and ClinicalTrials.gov databases for articles published from inception to June 24, 2022, without language restrictions.
520			_aImportance: The effect of shared decision-making (SDM) and the extent of its use in interventions to improve cardiovascular risk remain unclear.
520			_aMain Outcomes and Measures: Decisional outcomes, cardiovascular risk factor outcomes, and health behavioral outcomes.
520			_aObjective: To assess the extent to which SDM is used in interventions aimed to enhance the management of cardiovascular risk factors and to explore the association of SDM with decisional outcomes, cardiovascular risk factors, and health behaviors.
520			_aResults: This review included 57 RCTs with 88578 patients and 1341 clinicians. A total of 59 articles were included, as 2 RCTs were reported twice. Nearly half of the studies (29 [49.2%]) tested interventions that targeted both patients and clinicians, and an equal number (29 [49.2%]) exclusively focused on patients. More than half (32 [54.2%]) focused on diabetes management, and one-quarter focused on multiple cardiovascular risk factors (14 [23.7%]). Most studies (35 [59.3%]) assessed cardiovascular risk factors and health behaviors as well as decisional outcomes. The quality of studies reviewed was low to fair. The SDM intervention was associated with a decrease of 4.21 points (95% CI, -8.21 to -0.21) in Decisional Conflict Scale scores (9 trials; I2 = 85.6%) and a decrease of 0.20% (95% CI, -0.39% to -0.01%) in hemoglobin A1c (HbA1c) levels (18 trials; I2 = 84.2%).
520			_aStudy Selection: Randomized clinical trials (RCTs) comparing SDM-based interventions with standard of care for cardiovascular risk factor management were included.
546			_aEnglish
650			_a*Decision Making, Shared
650			_a*Health Behavior
650			_aDatabases, Factual
650			_aGlycated Hemoglobin
650			_aHeart Disease Risk Factors
650			_aHumans
650			_zAutomated
651			_aMedStar National Rehabilitation Network
657			_aJournal Article
657			_aMeta-Analysis
657			_aSystematic Review
700			_aNmezi, Nwakaego _bMNRN
790			_aElias S, Chen Y, Liu X, Slone S, Turkson-Ocran RA, Ogungbe B, Thomas S, Byiringiro S, Koirala B, Asano R, Baptiste DL, Mollenkopf NL, Nmezi N, Commodore-Mensah Y, Himmelfarb CRD
856			_uhttps://dx.doi.org/10.1001/jamanetworkopen.2024.3779 _zhttps://dx.doi.org/10.1001/jamanetworkopen.2024.3779
942			_cART _dArticle
999			_c14323 _d14323