Engaging Women in Decisions About Their Heart Health

Women living with cardiovascular disease face many health decisions throughout their journey. Most women want more information and greater involvement in decision-making about their health in partnership with their clinicians. Yet, facing these decisions can lead to a sense of personal uncertainty about the best course of action. The individualized and intentional communication offered by a shared decision-making approach is particularly important for women with cardiovascular disease, given the limited availability of scientific data about women regarding the risks and benefits for screening and treatment options, making the elicitation and incorporation of personal preferences and values in their decision-making critical. Further, sex and gender considerations are important in shared decision-making particularly as they are associated with various decision-making styles, communication styles, and values and preferences which can influence an individual’s preferred option. In this chapter, we begin by providing a definition of shared decision-making and discuss the evidence related to women’s involvement in health decisions, particularly for cardiovascular conditions. We present the evidence supporting interventions to facilitate shared decision-making in clinical practice such as patient decision aids, decision coaching and question prompt lists. Finally, we present considerations for shared decision-making implementation in clinical practice. Throughout, we highlight opportunities for meaningful patient engagement amidst the challenges of shared decision-making to achieve true patient-centered care for women living with cardiovascular disease.