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NCT Number: NCT06567626

Decision Support Tool for Revascularisation Options in Coronary Artery Disease

Together with patients and healthcare professionals, we want to design a Decision Support Tool (DST) that will help people with coronary artery disease to understand and choose treatments that best reflect their preferences and values.

Coronary artery disease (CAD) is a leading cause of death. Blood vessels supplying oxygen to the heart muscle become narrowed by a gradual build-up of fatty material. This can result in heart attacks, heart failure, and sudden death. One way to treat the blockage is by inserting an inner sleeve called a "stent" into the blood vessel and clearing the blockage by forcing it into the artery wall. Another method involves diverting the blood supply around the blockage using a vessel harvested from another body site; this is called "bypass surgery". The best treatment, either stents or surgery, is different for everyone.

A Decision Support Tool (DST) will provide key information on the pros and cons of stents or surgery and how these match an individual's preferences and values. People are then empowered to make shared decisions about treatment with their doctors. Personalising treatment decisions in this way can reduce inequalities in care and improve shared decision making. Our proposed research will develop a DST in the form of a webpage with alternative print material for those at risk of digital poverty. The DST will be developed in multiple languages to improve accessibility.

There are two parts to the study: the first part will use the experience of patients, who have already had stent or surgery, and healthcare professionals to design and refine a DST prototype; this will be done through workshops, focus groups, and cognitive interviews. The second part will test whether it is possible to use the DST by people with CAD waiting for a procedure; this will be done through questionnaires and interviews. The result of this study can then subsequently inform an assessment of the refined DST on a national level, with the hopes of enabling more effective shared decision making.

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Key information

Sex eligibility

All sexes

Study type

Observational

Primary location

University Hospitals of Leicester, Leicester, United Kingdom

Loading trial locations.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

WP1. DST CO-DESIGN PATIENT PARTICIPANTS

Inclusion criteria

Participants may enter the study if ALL of the following applies:

  • Any adult (≥ 18 years) with lived experience of coronary revascularisation
  • Willing and able to consent to study participation.
  • Able to understand written and spoken English for decisional needs workshop or focus groups (NB this criterion is not required for cognitive interviews or acceptability questionnaire)

Exclusion criteria

Participants may not enter the study if they are unable to provide informed consent. Individuals who participate in focus groups are ineligible for subsequent participation in cognitive interviews and acceptability questionnaires.

WP1. DST CO-DESIGN HCP PARTICIPANTS

Inclusion criteria

Participants may enter the study if ALL of the following applies:

  • Healthcare professional with a patient-facing clinical role which involves decision making regarding coronary revascularisation
  • Willing and able to consent to study participation.
  • Able to understand written and spoken English

Exclusion criteria

Participants may not enter the study if they are unable to provide informed consent.

WP2. DST FEASIBILITY PATIENT PARTICIPANTS

Inclusion criteria

Participants may enter the study if ALL of the following applies:

  • Adult (≥ 18 years) awaiting coronary revascularisation
  • Has received coronary angiography for definitive diagnosis.
  • Willing and able to consent to study participation.
  • Able to understand written and spoken English, Polish, Romanian, Urdu, Panjabi, or Gujarati

Exclusion criteria

Participants may not enter the trial if ANY of the following apply:

  • Where clinical consensus strongly recommends one option of revascularisation over another
  • Unable to provide informed consent
  • Unable to speak one of the aforementioned 6 languages

WP2. DST FEASIBILITY HCP PARTICIPANTS

Inclusion criteria

Participants may enter the study if ALL of the following applies:

  • Healthcare professional with a patient-facing clinical role which involves decision making regarding coronary revascularisation
  • Willing and able to consent to study participation.
  • Able to understand written and spoken English

Exclusion criteria

Participants may not enter the study if they are unable to provide informed consent.

Treatment and study plan

Decision Support Tool (DECIDE-CAD)

Other

DECIDE-CAD is a decision support tool - designed using mixed methods through this study - which aims to enable shared decision making with people who are considering revascularisation options for coronary artery disease.

Primary outcomes

  1. Rate of eligibility

    Time frame: 6 months

    Eligibility will be calculated as all patients eligible for study participation as a proportion of all patients who receive ACS treatment during the study period.

  2. Rate of enrolment

    Time frame: 6 months

    Enrolment will be calculated as patients who provide informed consent and receive the DST as a proportion of all eligible patients.

  3. Rate of attrition

    Time frame: 6 months

    Attrition will be calculated as patients who do not complete the study as a proportion of all patients enrolled.

Secondary outcomes

  1. Decisional Conflict

    Time frame: 6 weeks

    Level of decisional conflict, measured using Decisional Conflict Scale before and after revascularisation procedure.

  2. Acceptability

    Time frame: 6 weeks

    User acceptability of decision support tool, measured using researcher-generated questionnaire after revascularisation procedure.

  3. Knowledge

    Time frame: 6 weeks

    User knowledge about revascularisation options, measured using researcher-regenerated questionnaire before and after revascularisation procedure.

  4. Preference

    Time frame: 6 weeks

    User preference about revascularisation options, measured using Control Preference Scale and Patients Preferences Questionnaire for Angina treatment before and after revascularisation procedure.

  5. Satisfaction with decision

    Time frame: 6 weeks

    User satisfaction with decision, measured using Satisfaction with Decision Scale after revascularisation procedure.

  6. Decision Regret

    Time frame: 6 weeks

    Degree of decision regret about revascularisation treatment received, measured using Decision Regret Scale after revascularisation procedure

  7. Treatment concordance

    Time frame: 6 weeks

    Concordance between user's preferred procedure and the treatment received, assessed after revascularisation procedure.

  8. Level of shared decision making

    Time frame: 6 weeks

    Level of shared decision making experienced by the user, measured using Shared Decision Making Questionnaire (SDM-Q-9) after revascularisation procedure.

  9. Health status

    Time frame: 6 weeks

    Health status measured using 20-item Short Form Survey before and after revascularisation procedure.

Study contacts

Contact information is provided by the study sponsor or research team.

Dr Ann Cheng

CONTACT

[email protected]

0116 252 2101

Sponsors and collaborators

Lead sponsor

University of Leicester

Other

Collaborators

  • University Hospitals, Leicester

Registry information

Official study title

Mixed Methods Co-design and Evaluation of a DECIsion Support Tool to Enable Shared DEcision Making With People Who Are Considering Revascularisation Options for Coronary Artery Disease

Acronym: DECIDE-CAD

Important dates

Study start
2024
Primary completion
2027
Study completion
2027
First posted
Aug 23, 2024
Registry last updated
Apr 3, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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