Professor Felicity Astin

Background: Questionnaires sent to over 70,000 NHS patients in 2020 show that people do not feel fully involved in making decisions about their healthcare. Patients should be at the centre of decision-making about their treatments, but often they are not. Patients with angina (chest pain/discomfort), are one group that face a tricky decision. They are already treated with medications but may have the option of planned coronary angioplasty treatment as well. This treatment may improve their chest pain/discomfort but has more serious complications than treatment with medicines alone. So, patients should fully understand their options, so they can make a decision that is right for them. Earlier work we have done showed that almost half of patients treated with planned coronary angioplasty are not fully involved in decision-making, do not understand the information they are given, and misunderstood the risks and benefits of coronary angioplasty treatment. Something we want to change. Patient decision aids (PtDAs) are more than just educational ‘tools’. When used by patients and health professionals they improve the ‘quality’ of: 1) The decisions made, and 2) The decision-making process. There are no good quality UK 'coronary angioplasty' PtDAs available. So, we co-created a web-based one, called ‘CONNECT’ which shows 'promise'. Aim: We want to test CONNECT, in a larger study (trial), to see if it improves the quality of shared decision-making. But trials are expensive, so we need to do some groundwork first to know what works best. In this preliminary fact-finding study, run over 24-months, we will ask 8 NHS Cardiac Centres, and 320 of their angina patients, about what approaches will work best to run a future trial and how they felt about being involved in the study. Design/methods: We will evaluate 1) our plans for the future trial design; and 2) the acceptability and practicality of CONNECT to users. We will collect information (using forms, questionnaires and interviews), to understand who will take part and whether enough people and Cardiac Centres agree to try CONNECT. We will also see if our plan for the future trial will work, whether patients and NHS staff like CONNECT, and how it might fit within NHS cardiology services. Patient and Public Involvement (PPI): We have worked with 121 expert patients and 65 health professionals, over a 2-year period, to understand their priorities and help us to co-create CONNECT to meet their needs. An expert patient/co-applicant and an experienced PPI lead will coordinate involvement throughout our study. Dissemination: To get our research ‘out there’ to benefit others, we will share findings through our established international network of expert patients and health professionals to influence policy and practice. We will publish and present findings and run a national conference.