{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T20:00:17Z","timestamp":1770235217671,"version":"3.49.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Out-of-pocket medication costs for patients who have heart failure with reduced ejection fraction may be an important part of shared decision-making, but cost has generally been excluded from clinical discussions. This study reports patients\u2019 perspectives on a decision aid for sacubitril\/valsartan that explicitly addresses out-of-pocket costs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Structured, in-depth interviews were conducted with 20 patients with heart failure with reduced ejection fraction from 2 medical centers to elicit their views on a publicly available decision aid for sacubitril\/valsartan that explicitly incorporates considerations related to out-of-pocket costs. Qualitative descriptive analysis was conducted.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Key themes identified were general enthusiasm for decision aids for medication decisions, openness on the part of patients to incorporation of cost into decision-making and the decision aid, requests for greater specificity regarding patient-specific cost, and challenges communicating evidence of benefit in a way that allows patients to make cost-benefit analyses for themselves. Patients also raised questions regarding logistical challenges of incorporating a decision aid into the normal clinical and decision-making workflow.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Patients were receptive to the inclusion of out-of-pocket cost as relevant in a decision aid for sacubitril\/valsartan. Key challenges to effective integration of cost in these decisions include developing mechanisms for acquiring reliable patient-specific cost estimates and addressing patients\u2019 difficulties (and sometimes skepticism) applying trial evidence to their own situation. In addition, implementation strategies are important to develop to facilitate decision aid integration for routine medical decisions into clinic workflow.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.120.007070","type":"journal-article","created":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T10:35:19Z","timestamp":1607682919000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Show Me the Money"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4415-3861","authenticated-orcid":true,"given":"Neal W.","family":"Dickert","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Emory University School of Medicine, ECCRI, Atlanta, GA (N.W.D., A.R.M., A.A.M., C.D.S.)."},{"name":"Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA (N.W.D.)."},{"name":"Emory Center for Ethics, Atlanta, GA (N.W.D.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea R.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Emory University School of Medicine, ECCRI, Atlanta, GA (N.W.D., A.R.M., A.A.M., C.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace E.","family":"Venechuk","sequence":"additional","affiliation":[{"name":"Adult and Child Consortium for Outcomes Research and Delivery Science (G.E.V., D.D.M., K.J.P., L.A.A.), University of Colorado School of Medicine, Aurora."},{"name":"Center for Demography of Health and Aging, University of Wisconsin-Madison (G.E.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9597-9642","authenticated-orcid":true,"given":"Daniel D.","family":"Matlock","sequence":"additional","affiliation":[{"name":"Adult and Child Consortium for Outcomes Research and Delivery Science (G.E.V., D.D.M., K.J.P., L.A.A.), University of Colorado School of Medicine, Aurora."},{"name":"Division of Geriatric Medicine (D.D.M.), University of Colorado School of Medicine, Aurora."},{"name":"Veterans Affairs Eastern Colorado Geriatric Research Education and Clinical Center, Denver (D.D.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda A.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA (M.A.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8033-3707","authenticated-orcid":true,"given":"Alanna A.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Emory University School of Medicine, ECCRI, Atlanta, GA (N.W.D., A.R.M., A.A.M., C.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth J.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Adult and Child Consortium for Outcomes Research and Delivery Science (G.E.V., D.D.M., K.J.P., L.A.A.), University of Colorado School of Medicine, Aurora."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candace D.","family":"Speight","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Emory University School of Medicine, ECCRI, Atlanta, GA (N.W.D., A.R.M., A.A.M., C.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry A.","family":"Allen","sequence":"additional","affiliation":[{"name":"Adult and Child Consortium for Outcomes Research and Delivery Science (G.E.V., D.D.M., K.J.P., L.A.A.), University of Colorado School of Medicine, Aurora."},{"name":"Division of Cardiology (L.A.A.), University of Colorado School of Medicine, Aurora."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2001.10412.x"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2017.12.014"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2012-0279"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1306826"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X13501721"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1280"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.7326\/M18-1608"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.853"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.006255"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000435"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.2223"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.010635"},{"key":"e_1_3_4_15_2","unstructured":"Cardiosmart. A Decision Aid for Renin-Angiotensin Inhibitor Drug Options for Patients with Heart Failure. 2017. Accessed October 12 2020. https:\/\/www.cardiosmart.org\/docs\/default-source\/assets\/decision-aid\/heart-failure-drug-options.pdf?sfvrsn=aaff9c98_1."},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-5-201203060-00008"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djr318"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.04.018"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.3680"}],"container-title":["Circulation: Cardiovascular Quality and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.120.007070","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T03:54:54Z","timestamp":1715572494000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.120.007070"}},"subtitle":["Patients\u2019 Perspectives on a Decision Aid for Sacubitril\/Valsartan Addressing Out-of-Pocket Cost"],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1161\/CIRCOUTCOMES.120.007070"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.120.007070","relation":{},"ISSN":["1941-7713","1941-7705"],"issn-type":[{"value":"1941-7713","type":"print"},{"value":"1941-7705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]},"assertion":[{"value":"2020-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e007070"}}