Factors influencing the decision to accept or decline aortic valve replacement for asymptomatic aortic stenosis: a nested longitudinal qualitative substudy of the EASY-AS randomised trial.

What was studied

This study looked at how people decide on a heart valve treatment. The main trial is for people with severe aortic stenosis but no symptoms. Aortic stenosis is a heart valve problem. The study was part of that larger trial in the UK. That trial compares replacing the valve early with waiting and watching. Researchers held talks with some trial patients and their family. They also spoke with some people who said no to the trial.

What they found

There were 73 interviews with 41 people. Few knew much about the condition before they were told they had it. Not knowing what would happen was a big worry. People wanted sound facts about symptoms and how things would change. Some felt uneasy about major treatment with no symptoms. Still, nobody fully objected to the idea. People who refused the trial had personal reasons, like home life or age. Some who said yes thought the condition was serious and would get worse. Some wanted to avoid long waits. Some trusted their doctors' views. People also wanted a say in the type of valve treatment. In 32 later interviews, people in the early group were content. Some had problems early in recovery, more so after valve surgery.

What it means for patients

The authors say people will likely accept major treatment when evidence backs it. Personal life still plays a big part in the choice. When a condition is not well known, people lean on doctors and other sources. The authors say working with patient groups on decision tools may help.

Why it is not certain yet

This study is based on talks, not a test of which treatment works. Only some people from select trial sites took part. The main trial is still going on. The abstract does not say how long people were followed.

Source

Factors influencing the decision to accept or decline aortic valve replacement for asymptomatic aortic stenosis: a nested longitudinal qualitative substudy of the EASY-AS randomised trial.

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