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Original research
Shared decision making in cardiology: a systematic review and meta-analysis
  1. Panagiota Mitropoulou1,
  2. Nicolai Grüner-Hegge2,
  3. Johannes Reinhold3,4,
  4. Charikleia Papadopoulou2,5
  1. 1Cardiology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2Department of Cardiology, Royal Papworth Hospital, Cambridge, UK
  3. 3Norwich Medical School, University of East Anglia, Norwich, UK
  4. 4Department of Cardiology, Norfolk and Norwich University Hospitals, Norwich, UK
  5. 5Department of Medicine, University of Cambridge, Cambridge, UK
  1. Correspondence to Dr Johannes Reinhold, University of East Anglia, Norwich NR4 7TJ, UK; j.reinhold{at}; Dr Charikleia Papadopoulou; cp461{at}


Objectives To evaluate the effectiveness of interventions to improve shared decision making (SDM) in cardiology with particular focus on patient-centred outcomes such as decisional conflict.

Methods We searched Embase (OVID), the Cochrane library, PubMed and Web of Science electronic databases from inception to January 2021 for randomised controlled trials that investigated the effects of interventions to increase SDM in cardiology. The primary outcomes were decisional conflict, decisional anxiety, decisional satisfaction or decisional regret; a secondary outcome was knowledge gained by the patients.

Results Eighteen studies which reported on at least one outcome measure were identified, including a total of 4419 patients. Interventions to increase SDM had a significant effect on reducing decisional conflict (standardised mean difference (SMD) −0.211, 95% CI −0.316 to −0.107) and increasing patient knowledge (SMD 0.476, 95% CI 0.351 to 0.600) compared with standard care.

Conclusions Interventions to increase SDM are effective in reducing decisional conflict and increasing patient knowledge in the field of cardiology. Such interventions are helpful in supporting patient-centred healthcare and should be implemented in wider cardiology practice.

  • meta-analysis

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • JR and CP are joint senior authors.

  • PM and NG-H are joint first authors.

  • Twitter @DrJReinhold

  • Contributors PM and NG-H: conceptualisation, methodology, validation, investigation, writing (review and editing), and contributed equally to this paper; JR: conceptualisation, methodology, validation, investigation and writing (original draft), project administration and guarantor; CP: conceptualisation, methodology, validation, investigation, writing (review and editing), project administration and supervision; PM and NG-H: contributed equally to this paper; JR and CP: contributed equally to this paper.

  • Funding JR and CP received funding from the National Institute for Health and Care Research as part of the clinical lecturer scheme.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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