Abstract 4368845: Greater Involvement in Shared Decision-Making is Associated with Better Self-Reported Health in US Adults and Those Living with Cardiometabolic Conditions

Abstract

Background: Shared decision-making (SDM) has been recommended to promote person-centered outcomes among adults with cardiovascular diseases. Yet, the associations between SDM and self-reported health status among US adults and those living with cardiometabolic conditions, and how these associations are different by age, have not been studied. Research Questions: What is the association between perceived SDM and self-reported health status among US adults and those living with cardiometabolic conditions, stratified by age? Methods: This cross-sectional study utilized data from the 2022 and 2024 Health Information National Trends Survey (HINTS 6 and HINTS 7) among US adults and those with cardiometabolic conditions such as heart disease, diabetes, and hypertension. The exposure was whether patients were always involved in SDM (Yes/No) during the past 12 months. The outcome of interest was adults’ self-reported health status, which was categorized as “excellent/very good/good” and “fair/poor”. Analyses were weighted according to HINTS 7 methodology. We performed weighted sequential multivariable logistic regression models stratified by age (18 to 65 and ≥65 years). The fully adjusted model included demographics and chronic diseases. Results: We included 11,660 adults [mean (SD) age: 50 (17.5) years], of whom 6,034 (52%) were living with cardiometabolic conditions. About 6,053 (weighted percentage: 51.7%) adults reported “always” involved in SDM. Findings from all samples and among those living with cardiometabolic conditions were similar in direction and magnitude of association (Table). In the fully adjusted analysis, individuals with cardiometabolic conditions who were always involved in SDM reported approximately 10 times higher odds of better health status [adjusted odds ratio (aOR): 9.72, 95% CI: 6.05-15.61]. The higher odds of better health were around 9 and 14 times higher among those living with cardiometabolic conditions who were less than 65 years (aOR: 8.82, 95% CI: 5.14-15.12) and 65 years and older (aOR: 14.30, 95% CI: 7.31-27.99), respectively. Conclusions: Although around half of the participants reported always being involved in SDM, greater involvement in SDM was associated with better self-reported health status, including those with cardiometabolic conditions, regardless of age. This highlights the importance of SDM in enhancing overall health outcomes.