Factors influencing the decision of older adults to be assessed for transcatheter XXXX : An exploratory study.

@entity1 @entity472 @entity886
BACKGROUND: Transcatheter @entity886 (TAVI) is the recommended therapy for @entity1 with severe @entity472 at increased surgical risk and likely to derive benefit. Multimodality and multidisciplinary assessment is required for the heart team to determine eligibility for TAVI in a primarily older population. Little is known about @entity1 ' motivation and perspectives on making the decision to undergo the complex assessment. AIMS: To explore factors influencing @entity1 ' decision making to undergo TAVI eligibility assessment to inform practice, programme development, health policy and future research. METHODS: An exploratory qualitative approach was used. Semistructured interviews were conducted with 15 @entity1 at the time of their referral for assessment to a quaternary cardiac and high volume TAVI centre. RESULTS: Multiple, intersecting factors that included biomedical, functional, social and environmental considerations influenced @entity1 ' decision. The six distinct factors were symptom burden, @entity1 ' perception as 'experienced' @entity1 , expectations of benefit and risks, healthcare system and informal support, logistical barriers and facilitators, and obligations and responsibilities. CONCLUSIONS: The decision to undergo TAVI eligibility assessment is multifaceted and complex. Programmatic processes of care must be in place to facilitate appropriate and @entity1 -centered decision making and access to TAVI. Strategies are required to mitigate the risks associated with the rapid deterioration of severe @entity472 , address @entity1 and referring physicians' education needs, and provide individualised care and equitable access. Future research must focus on @entity1 ' experiences throughout the trajectory of TAVI care.
