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Information sheets for patients with acute chest pain: randomised controlled trial.

Arnold J, Goodacre S, Bath P, Price J - BMJ (2009)

Bottom Line: Secondary outcomes were depression (hospital anxiety and depression scale), health related quality of life (SF-36), patient satisfaction, presentation with further chest pain within one month, lifestyle change (smoking cessation, diet, exercise), further information sought from other sources, and planned healthcare seeking behaviour in response to further pain. 494 of 700 (70.6%) patients responded.The information sheet had no significant effect on satisfaction with care, subsequent symptoms, lifestyle change, information seeking, or planned actions in the event of further pain.Provision of an information sheet to patients with acute chest pain can reduce anxiety and depression and improve mental health and perception of general health but does not alter satisfaction with care or other outcomes.

View Article: PubMed Central - PubMed

Affiliation: Northern General Hospital, Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield S5 7AU. Jane.Arnold@sth.nhs.uk

ABSTRACT

Objectives: To determine whether providing an information sheet to patients with acute chest pain reduces anxiety, improves health related quality of life, improves satisfaction with care, or alters subsequent symptoms or actions.

Design: Single centre, non-blinded, randomised controlled trial.

Setting: Chest pain unit of an emergency department.

Participants: 700 consecutive patients with acute chest pain and no clear diagnosis at initial presentation.

Interventions: After a diagnostic assessment patients were randomised to receive either standard verbal advice or verbal advice followed by an information sheet.

Main outcome measures: The primary outcome was anxiety (hospital anxiety and depression scale). Secondary outcomes were depression (hospital anxiety and depression scale), health related quality of life (SF-36), patient satisfaction, presentation with further chest pain within one month, lifestyle change (smoking cessation, diet, exercise), further information sought from other sources, and planned healthcare seeking behaviour in response to further pain.

Results: 494 of 700 (70.6%) patients responded. Compared with those receiving standard verbal advice those receiving advice and an information sheet had lower mean hospital anxiety and depression scale scores for anxiety (7.61 v 8.63, difference 1.02, 95% confidence interval 0.20 to 1.84) and depression (4.14 v 5.28, difference 1.14, 0.41 to 1.86) and higher scores for mental health and perception of general health on the SF-36. The information sheet had no significant effect on satisfaction with care, subsequent symptoms, lifestyle change, information seeking, or planned actions in the event of further pain.

Conclusions: Provision of an information sheet to patients with acute chest pain can reduce anxiety and depression and improve mental health and perception of general health but does not alter satisfaction with care or other outcomes.

Trial registration: Current Controlled Trials ISRCTN85248020.

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Related in: MedlinePlus

Patient flow through trial
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Related In: Results  -  Collection

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fig1: Patient flow through trial

Mentions: Between May 2006 and September 2007, 700 patients (349 intervention, 351 control) were recruited to the study (figure). An additional 167 patients (mean age 56.9 years, 89/167 (53%) men) were also considered during this period: 32 declined participation, 19 had cognitive impairment and were unable to provide informed consent, 27 did not understand written English, 37 were either admitted for inpatient care or did not complete the chest pain unit’s protocol, and details were missing for two. A further 50 patients were willing to join the trial but were excluded because the chest pain nurses thought that none of the information sheets was appropriate to their diagnosis. Also, four patients who agreed to participate had to be withdrawn before randomisation because of a sudden change in either their condition or the doctor’s opinion.


Information sheets for patients with acute chest pain: randomised controlled trial.

Arnold J, Goodacre S, Bath P, Price J - BMJ (2009)

Patient flow through trial
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2651103&req=5

fig1: Patient flow through trial
Mentions: Between May 2006 and September 2007, 700 patients (349 intervention, 351 control) were recruited to the study (figure). An additional 167 patients (mean age 56.9 years, 89/167 (53%) men) were also considered during this period: 32 declined participation, 19 had cognitive impairment and were unable to provide informed consent, 27 did not understand written English, 37 were either admitted for inpatient care or did not complete the chest pain unit’s protocol, and details were missing for two. A further 50 patients were willing to join the trial but were excluded because the chest pain nurses thought that none of the information sheets was appropriate to their diagnosis. Also, four patients who agreed to participate had to be withdrawn before randomisation because of a sudden change in either their condition or the doctor’s opinion.

Bottom Line: Secondary outcomes were depression (hospital anxiety and depression scale), health related quality of life (SF-36), patient satisfaction, presentation with further chest pain within one month, lifestyle change (smoking cessation, diet, exercise), further information sought from other sources, and planned healthcare seeking behaviour in response to further pain. 494 of 700 (70.6%) patients responded.The information sheet had no significant effect on satisfaction with care, subsequent symptoms, lifestyle change, information seeking, or planned actions in the event of further pain.Provision of an information sheet to patients with acute chest pain can reduce anxiety and depression and improve mental health and perception of general health but does not alter satisfaction with care or other outcomes.

View Article: PubMed Central - PubMed

Affiliation: Northern General Hospital, Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield S5 7AU. Jane.Arnold@sth.nhs.uk

ABSTRACT

Objectives: To determine whether providing an information sheet to patients with acute chest pain reduces anxiety, improves health related quality of life, improves satisfaction with care, or alters subsequent symptoms or actions.

Design: Single centre, non-blinded, randomised controlled trial.

Setting: Chest pain unit of an emergency department.

Participants: 700 consecutive patients with acute chest pain and no clear diagnosis at initial presentation.

Interventions: After a diagnostic assessment patients were randomised to receive either standard verbal advice or verbal advice followed by an information sheet.

Main outcome measures: The primary outcome was anxiety (hospital anxiety and depression scale). Secondary outcomes were depression (hospital anxiety and depression scale), health related quality of life (SF-36), patient satisfaction, presentation with further chest pain within one month, lifestyle change (smoking cessation, diet, exercise), further information sought from other sources, and planned healthcare seeking behaviour in response to further pain.

Results: 494 of 700 (70.6%) patients responded. Compared with those receiving standard verbal advice those receiving advice and an information sheet had lower mean hospital anxiety and depression scale scores for anxiety (7.61 v 8.63, difference 1.02, 95% confidence interval 0.20 to 1.84) and depression (4.14 v 5.28, difference 1.14, 0.41 to 1.86) and higher scores for mental health and perception of general health on the SF-36. The information sheet had no significant effect on satisfaction with care, subsequent symptoms, lifestyle change, information seeking, or planned actions in the event of further pain.

Conclusions: Provision of an information sheet to patients with acute chest pain can reduce anxiety and depression and improve mental health and perception of general health but does not alter satisfaction with care or other outcomes.

Trial registration: Current Controlled Trials ISRCTN85248020.

Show MeSH
Related in: MedlinePlus