Chest pain patients educated about risk more likely to opt out of stress test
Chest pain patients educated about their future heart attack risk and involved in deciding care options were more likely than less-aware patients to opt out of stress testing, according to research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.
Chest pain, the second most common reason people seek emergency care at U.S. hospitals, accounts for 8 million patient visits and about $8 billion in healthcare costs annually, researchers said.
"To avoid missing a diagnosis of heart attack, emergency physicians often admit patients to observation units for stress testing, even though patients are at a very low risk for heart attack," said Erik P. Hess, M.D., M.Sc., lead author of the study and emergency room (ER) consultant at the Mayo Clinic in Rochester, Minn. "This results in false positive test results, unnecessary additional procedures, exposure to radiation and increased cost."
Hess and colleagues, investigating how care might change if patients were more educated about their health care, designed a decision aid (visual patient-education tool) about care options and 45-day risk of a heart attack.
Then, they studied 204 emergency department chest pain patients being considered for stress testing. Half the patients received the decision aid and half didn't.
After conducting surveys immediately after the ER visit to test patients' knowledge and analyze involvement in decision-making, researchers found:
- Decision-aid patients decided to be admitted to the observation unit for stress testing 58 percent of the time compared to 77 percent for patients in the traditional care group.
- Patients in the decision-aid group were much more knowledgeable about their heart attack risk and options than those in the traditional care group.
- The degree of involvement in care decisions in patients who received the decision aid was four times greater than those who didn't receive the decision aid.
- Patients in the decision-aid group said the information was clear and helpful, and three of four surveyed said they would recommend it to others.
- No major adverse heart problems occurred within 30 days of discharge in either group.
To confirm results of this study conducted in one hospital, Hess said researchers should test the decision aid in many different emergency departments.
"Use of the decision aid requires close collaboration between emergency physicians and cardiologists so patients can receive follow-up care 24 to 72 hours after they leave the emergency room," Hess said. "So, the use of the decision aid will be more difficult in healthcare settings with less reliable access to outpatient follow-up."
Provided by American Heart Association
- Small change makes big difference in compliance rates for follow-up stress test after chest pain Mar 26, 2012 | not rated yet | 0
- Study reveals safety of CT scans for rapid rule out of heart attacks in ER chest pain patients Mar 26, 2012 | not rated yet | 0
- In the Chest Pain E.R., a new testing routine means fewer missed heart disease cases Aug 25, 2011 | not rated yet | 0
- Chest pain? New system helps to determine whether to head to ER Dec 15, 2010 | not rated yet | 0
- ED chest pain units and physician discretion may lower stress test use Mar 26, 2012 | not rated yet | 0
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Indeterminism in Classical Physics
1 hour ago I was reading the Roger Penrose book Emperor's New Mind and he was explaining the determinism in Newtonian mechanics. He says that if we consider...
Current in two wires
1 hour ago Wire A and B, which have the same cross-sectional area are connected in series. There is a p.d. V across the whole wire. Suppose the two wires...
understanding the dipole model for Rayleigh scattering
3 hours ago Hello. I am currently studying scattering theory in detail for my BSc thesis, and I'm starting with Rayleigh scattering. I'm following Scattering...
question on coriolis effect with drag force
9 hours ago I really need help with this question. A small floating object initially moves with velocity v on the surface of a liquid at latitude λ. The...
Question of reflection and transmission of TEM wave in normal incidenc
15 hours ago Suppose TEM wave in +z normal to a boundary on xy plane at z=0. We know *E* & *H* are tangential to the boundary. Let ##\vec E_i=\hat x E##, be the...
the rudyak-krasnolutski effective potencial
16 hours ago Hi ... anyone now how to calculate or the formula of the rudyak-krasnolutski EFFECTIVE potencial ? the effective potencial includes the angular...
- More from Physics Forums - Classical Physics
More news stories
(HealthDay)—In patients who have previously been considered difficult to image, dual-source cardiac (DSC) computed tomography (CT) can identify clinically significant coronary artery disease, according ...
Cardiology 13 hours ago | not rated yet | 0
UCLA researchers examining outcomes for advanced heart-failure patients over the past two decades have found that, coinciding with the increased availability and use of new therapies, overall mortality has decreased and sudden ...
Cardiology 16 hours ago | not rated yet | 0
22 May 2013, Paris, France: The Lotus Valve, a second-generation transcatheter aortic valve implantation (TAVI) device, was successfully implanted in all of the first 60 patients in results from REPRISE II reported at EuroPCR ...
Cardiology 20 hours ago | not rated yet | 0
Costs to treat stroke are projected to more than double and the number of people having strokes may increase 20 percent by 2030, according to the American Heart Association/American Stroke Association.
Cardiology May 22, 2013 | not rated yet | 0
Blood thinners are the preferred treatment option to prevent heart attacks, blood clots and stroke, but they are not without risk, and not just because of their side effects. These high-risk drugs, known as anticoagulants, ...
Cardiology May 22, 2013 | not rated yet | 0
5 minutes ago | not rated yet | 0
50 seconds ago | not rated yet | 0 |
17 minutes ago | not rated yet | 0
23 minutes ago | not rated yet | 0
14 hours ago | 4.8 / 5 (6) | 0 |