BMC Med Inform Decis Mak. 2026 Jul 11;26(1):259. doi: 10.1186/s12911-026-03700-0.
ABSTRACT
BACKGROUND: Hypertension is a major cause of premature death and a modifiable risk factor for cardiovascular disease. Effective management includes both pharmacological treatment strategies, including antihypertensive medications, and non-pharmacological treatment strategies, such as lifestyle changes. Shared decision making (SDM) between patients and healthcare professionals is essential to determine the most appropriate treatment for hypertension. Patient decision aids (PDAs) facilitate SDM by providing information on treatment options and helping patients to clarify their values and preferences. However, there is no comprehensive comparison of PDAs for hypertension.
OBJECTIVE: This systematic review aimed to identify and evaluate PDAs for arterial hypertension using the International Patient Decision Aid Standards (IPDAS) criteria.
METHODS: A comprehensive search of bibliographic databases (PubMed, Embase) and gray literature (Google Scholar, Google) was performed in October 2023 and updated in April 2026. Studies and tools were included if they presented a PDA for patients with arterial hypertension, met the IPDAS definition of a PDA and were in German or English. Two researchers screened the literature, extracted data and assessed the quality of the PDAs using the IPDAS Minimal Criteria. Data were synthesized narratively.
RESULTS: Of 1,874 records screened, five PDAs met the inclusion criteria. These PDAs were developed between 2019 and 2024 and originated from the United States, United Kingdom, and Germany. All PDAs addressed the two option areas of medication and lifestyle but differed in the number of individual treatment options presented (range: 2-12 options) and the level of detail in which the options were addressed. All five PDAs were accessible online. Common design features of the PDAs included an option grid format for presenting treatment options with associated benefits and adverse effects, visuals and graphics to enhance comprehension, and value clarification. Quality assessments showed varying levels of compliance with the IPDAS criteria, with overall scores ranging from 49/116 to 87/116.
CONCLUSIONS: Few PDAs exist despite the prevalence of hypertension. PDAs varied in quality and format, highlighting gaps in the development process. Further research is needed to evaluate the effectiveness of PDAs for hypertension and to determine which formats are most effective in supporting SDM in different patient populations.
CLINICAL TRIAL NUMBER: Not applicable.
PMID:42436484 | DOI:10.1186/s12911-026-03700-0