A Comprehensive Approach to Decision Aids Supporting Shared Decision Making in Cardiac Rehabilitation

In recent years, patients' interest in taking control of their own health and rehabilitation has grown. Shared decision making (SDM) advocates for the involvement of patients in making preference-sensitive decisions about their health and care. Optimal support for patients' and healthcare professionals' participation in the SDM process builds on effective, comprehensive tools revealing available evidence and encouraging patient preference elicitation. Moreover, these tools can guide them through the SDM process and offer support during follow-up. Digital tools that facilitate SDM mainly focus on supporting patients when making major decisions. Educating patients about their options, while highlighting their associated benefits and risks, and fostering collaboration and discussion in the encounter are essential components in these tools. Nevertheless, it is important to give patients the support they need when making decisions with less impact at home and empower them to become active participants in their daily care. In the context of cardiac rehabilitation (CR), these levels of decision making are apparent. In this paper, we propose a framework of levels of decision making and a timeline for tools supporting shared decision making in CR. Furthermore, a categorization of SDM tools is presented. These contributions guide researchers aiming to empower patients, and keeping patients engaged and motivated throughout the CR program to make lifestyle changes.