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May 25, 2016

New Decision-Making Tool Improves Patient Satisfaction with Chest Pain Treatment

A simple pamphlet helps clarify treatment options for people in the ER for chest pain.

By offering a simple tool in emergency departments, patients with chest pain (angina) are able to make more informed decisions about their health care, based results of a recent trial presented in April at the American College of Cardiology’s 65th Annual Scientific Sessions.

Conducted at multiple health care sites across the U.S., this study tested a decision tool in patients with “low risk” chest pain. Patients had negative results for a heart attack but were eligible for additional testing to further assess the heart’s arteries.

Nearly 900 patients were included in the trial, half of whom were given the decision tool during their hospital visit. The pamphlet outlined their current diagnosis, personalized risk evaluation and treatment options. For example, it explained that patients were not having a heart attack and that they were eligible for stress or imaging tests to take a closer look at their heart. The pamphlet also explained that the patient’s short-term risk for heart attack was low and gave four treatment options:

  • I would like to have a stress test or coronary CT angiogram during my emergency visit. I realize this may increase the cost of my care and/or lengthen my stay.
  • I would like to be seen by a heart doctor within 24–72 hours and would like assistance in scheduling this appointment.
  • I would like to schedule an appointment on my own to consult with my primary care physician.
  • I would like my Emergency Department doctor to make this decision for me.

Overall, researchers found that patient satisfaction was much higher in patients that received this tool compared to those receiving standard care. In fact, both patients and providers reported that they would recommend the aid to other patients.

Researchers also found that the decision tool helped safely reduce testing without increasing future heart events. Among patients receiving the decision tool, only 37% were admitted to the hospital for additional testing, while 52% of patients receiving standard care stayed for testing. Risk of future heart events was similar among both groups.

According to authors, findings highlight the growing importance of shared decision making between patients and providers. It’s important that patients understand their diagnosis and treatment options, and tools like this help ensure that patients have the information they need to make informed decisions. Decision tools are especially useful in emergency settings, where patients are under added duress. With additional research, experts hope to confirm the benefits of decision tools and increase their use in emergency and outpatient settings.

Questions for You to Consider

  • What is angina?
  • Angina is chest pain brought on by a lack of oxygen supply to the heart. Angina can be recurring (chronic or stable angina) or can occur suddenly (unstable angina). It’s important to seek medical attention immediately if you experience unexplained chest pain, as it could be a sign of a heart attack.
  • How is angina treated?

  • Angina can be treated in a variety of ways, including lifestyle changes, medications, and medical procedures. For example, quitting smoking, losing weight and reducing stress can help successfully treat angina in some patients. For others, medications like beta blockers or procedures such as angioplasty and stenting may be necessary to treat the condition.

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