Cost Conversations About Anticoagulation Between Patients With Atrial Fibrillation and Their Clinicians

Key Points Question What factors contribute to cost conversations about anticoagulation treatment between patients with atrial fibrillation and their clinicians, and what outcomes are associated with these conversations? Findings In this cohort study of 830 audiovisual recordings of encounters and participant surveys from a randomized trial comparing atrial fibrillation care with and without a shared decision-making (SDM) tool, cost conversations were associated with the use of an SDM tool, with middle-income patients, and with consultations conducted by female primary care staff clinicians. Cost conversations were associated with patients’ decision-making processes but not final treatment choice. Meaning These findings suggest that SDM tools may inform efforts to promote cost conversations in practice, an important consideration when increasing costs of care are being passed on to patients.