title: Educational resources for patients considering a left ventricular assist device: a cross-sectional review of internet, print, and multimedia materials.
abstract: BACKGROUND
  Left ventricular assist devices (LVADs) are being used with increasing frequency to treat severe heart failure. Patients seek out informational resources when considering implantation. The primary study objective was to characterize the scope and quality of available LVAD educational materials.
  
  
  RESULTS
  In July 2013, we performed a cross-sectional search of Internet, print, and multimedia resources available to patients considering LVAD. Written materials <10 sentences, videos <2 minutes, and materials clearly directed to healthcare professionals were excluded. Seventy-seven materials met inclusion criteria. Potential benefits of LVAD therapy were discussed in all (n=77), whereas less often mentioned were risks (n=43), lifestyle considerations (n=29), surgical details (n=26), caregiver information (n=9), and hospice or palliative care (n=2). Of the 14 materials that recognized a decision or alternate treatment option, 7 used outdated statistics, 12 scored above an eighth grade reading comprehension level, and 12 met <50% of International Patient Decision Aid Standards criteria. In the survey participants rated all but one as biased toward accepting LVAD therapy.
  
  
  CONCLUSIONS
  Although many resources exist for patients considering an LVAD, the content is suboptimal. Benefits of LVADs are often presented in the absence of risks, alternative options, and caregiver considerations. Most materials use outdated statistics, are above the reading level of average Americans, and are biased toward accepting LVAD therapy. There is no tool that would qualify as a formal decision aid.
authors.affiliation: From the School of Medicine (M.C.I.), Divisions of General Internal Medicine (D.D.M.) and Cardiology (C.K.M., L.A.A.), and Colorado Health Outcomes Program (D.D.M., C.K.M., J.S.T., L.A.A.), University of Colorado School of Medicine, Aurora; Mechanical Circulatory Support Program, University of Colorado Hospital, Aurora (W.B.); and Section of Heart Failure and Cardiac Transplantation, Division of Cardiology, Department of Medicine, Washington University in St. Louis-School of Medicine, MO (S.J.L.).
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Iacovetto
authors.affiliation: From the School of Medicine (M.C.I.), Divisions of General Internal Medicine (D.D.M.) and Cardiology (C.K.M., L.A.A.), and Colorado Health Outcomes Program (D.D.M., C.K.M., J.S.T., L.A.A.), University of Colorado School of Medicine, Aurora; Mechanical Circulatory Support Program, University of Colorado Hospital, Aurora (W.B.); and Section of Heart Failure and Cardiac Transplantation, Division of Cardiology, Department of Medicine, Washington University in St. Louis-School of Medicine, MO (S.J.L.).
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Matlock
authors.affiliation: From the School of Medicine (M.C.I.), Divisions of General Internal Medicine (D.D.M.) and Cardiology (C.K.M., L.A.A.), and Colorado Health Outcomes Program (D.D.M., C.K.M., J.S.T., L.A.A.), University of Colorado School of Medicine, Aurora; Mechanical Circulatory Support Program, University of Colorado Hospital, Aurora (W.B.); and Section of Heart Failure and Cardiac Transplantation, Division of Cardiology, Department of Medicine, Washington University in St. Louis-School of Medicine, MO (S.J.L.).
authors.forename: Colleen K
authors.initials: CK
authors.lastname: McIlvennan
authors.affiliation: From the School of Medicine (M.C.I.), Divisions of General Internal Medicine (D.D.M.) and Cardiology (C.K.M., L.A.A.), and Colorado Health Outcomes Program (D.D.M., C.K.M., J.S.T., L.A.A.), University of Colorado School of Medicine, Aurora; Mechanical Circulatory Support Program, University of Colorado Hospital, Aurora (W.B.); and Section of Heart Failure and Cardiac Transplantation, Division of Cardiology, Department of Medicine, Washington University in St. Louis-School of Medicine, MO (S.J.L.).
authors.forename: Jocelyn S
authors.initials: JS
authors.lastname: Thompson
authors.affiliation: From the School of Medicine (M.C.I.), Divisions of General Internal Medicine (D.D.M.) and Cardiology (C.K.M., L.A.A.), and Colorado Health Outcomes Program (D.D.M., C.K.M., J.S.T., L.A.A.), University of Colorado School of Medicine, Aurora; Mechanical Circulatory Support Program, University of Colorado Hospital, Aurora (W.B.); and Section of Heart Failure and Cardiac Transplantation, Division of Cardiology, Department of Medicine, Washington University in St. Louis-School of Medicine, MO (S.J.L.).
authors.forename: William
authors.initials: W
authors.lastname: Bradley
authors.affiliation: From the School of Medicine (M.C.I.), Divisions of General Internal Medicine (D.D.M.) and Cardiology (C.K.M., L.A.A.), and Colorado Health Outcomes Program (D.D.M., C.K.M., J.S.T., L.A.A.), University of Colorado School of Medicine, Aurora; Mechanical Circulatory Support Program, University of Colorado Hospital, Aurora (W.B.); and Section of Heart Failure and Cardiac Transplantation, Division of Cardiology, Department of Medicine, Washington University in St. Louis-School of Medicine, MO (S.J.L.).
authors.forename: Shane J
authors.initials: SJ
authors.lastname: LaRue
authors.affiliation: From the School of Medicine (M.C.I.), Divisions of General Internal Medicine (D.D.M.) and Cardiology (C.K.M., L.A.A.), and Colorado Health Outcomes Program (D.D.M., C.K.M., J.S.T., L.A.A.), University of Colorado School of Medicine, Aurora; Mechanical Circulatory Support Program, University of Colorado Hospital, Aurora (W.B.); and Section of Heart Failure and Cardiac Transplantation, Division of Cardiology, Department of Medicine, Washington University in St. Louis-School of Medicine, MO (S.J.L.). larry.allen@ucdenver.edu.
authors.forename: Larry A
authors.initials: LA
authors.lastname: Allen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D019212:Multimedia; D010353:Patient Education as Topic / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies
keywords: heart failure; patient education as topic; ventricular assist device