Shared Decision-making: Effects on Cardiac Risk Factor Modification Behavior
Shared Decision-making: Effects on Cardiac Risk Factor Modification Behavior
Decision Aids (DA) to inform patients about health care options and help them to participate
 in their care choices are widely advocated. The main argument for offering patients a choice
 is that patients' preferences vary, and health professionals cannot always know what is
 "best" for an individual, specially when different outcomes have different benefits and risk
 profiles. The standard modes of treatment for patients with coronary artery disease (CAD) are
 coronary artery bypass graft (CABG) surgery, medication, and angioplasty. All three
 treatments for CAD work better when combined with cardiac risk factor modification behavior
 (CRFMB). CRFMB is important for the general public, but it is even more important for people
 with CAD because people with CAD have more at stake. In this RCT study we will evaluate the
 effectiveness of a CAD-DA with and witout an additional decision counseling program (DCP) on
 health outcomes and quality of life to improve enhancement of adherence to cardiac risk
 modification behavior. The CAD-DA is developed by the Ottawa Health Research Institute and
 Division of Clinical Epidemiology at Montreal General Hospital, for CAD patients facing the
 decision of making lifestyle changes to lower their cardiac risk factors. It provides
 patients with information about what they can you do to prevent the disease from progressing.
 The DCP is designed to systematically guide patients through the process of deciding what
 cardiac risk modification behaviors are important for them to carry out. A RCT where 360 CAD
 patients > 18 of age scheduled for an angiogram at Rikshospitalet University Hospital in
 Norway (RH) will be randomly assigned to: (1) CAD-DA group where subjects will receive, for
 take home, the CAD-DA prior to their scheduled angiogram; (2) DCP group where subjects in
 addition to the CAD-DA will receive an individual decisional counseling program (DCP) from a
 trained nurse counselor in their homes prior to their angiogram; and (3) the control group
 who will receive "usual care". Data will be collected at four points: at the initial visit
 (T1), 2 months (T2), 4 months (T3) and 6 (T4) months after angiogram
As above
Inclusion Criteria:

 -  Age 18 and older

 -  Scheduled for an angiogram

 -  Able to read, write, and speak Norwegian

 -  Live within approximately 100 km of Oslo

 -  Have a telephone

 Exclusion Criteria:

 - Cognitive impairment