News | Cardiac Diagnostics | April 07, 2016

Decision Aid Tool Improves Education for Emergency Chest Pain Patients

Mayo Clinic study shows patients who thoroughly discuss treatment with physician have improved knowledge of health status, follow-up options

Chest Pain Choice, emergency department, Mayo Clinic study, ACC 2016

April 7, 2016 — Emergency department patients with low-risk chest pain show improved knowledge of their health status and follow-up options after talking through treatment options with a physician, according to Mayo Clinic research. The study, presented at the American College of Cardiology (ACC) 65th Annual Scientific Session, compared these patients with those who received standard counseling from a physician.

Chest pain accounts for about 8 million emergency department visits each year in the United States, but more than 90 percent of those patients are not experiencing a heart attack, said Erik Hess, M.D., lead author and emergency medicine physician at Mayo Clinic. “An electrocardiogram and blood tests can tell us if a patient is having a heart attack. Further testing may be needed to tell us if a patient faces an increased risk of heart attack in the near future. We wanted to know if there is value in discussing this further testing with patients.”

In the study, which involved 898 patients visiting six emergency departments in five states, half of the patients were randomly assigned to receive a physician discussion using Chest Pain Choice, the first patient-oriented tool designed to help shared decision-making between patients and physicians for chest pain. Patients were shown one-page information sheets that provide descriptions and graphics depicting a patient’s specific risk, such as a 2 percent risk of having a heart attack in the next 45 days and the next steps for care.

Results showed that patients who received Chest Pain Choice increased their knowledge about their risk and options, answering 53 percent of questions on a questionnaire correctly, compared with 44.6 percent in the patients who received standard physician consultation. In addition, patients were asked to evaluate the experience of discussing their care with their physician. Of patients who received Chest Pain Choice, 68.9 percent said they would recommend the way they discussed care and options with their physicians, compared with 61.2 percent of those who received standard care.

“This trial shows that patient engagement in care can be beneficial to the patient’s understanding and treatment, and can lead to better care and more efficient use of resources,” Hess said, adding that Chest Pain Choice was associated with no major adverse heart events and led to a significantly lower proportion of patients receiving a stress test.

Co-authors are: Judd Hollander, M.D., Thomas Jefferson University; Jason Schaeffer, M.D., and Jeff Kline, M.D., both of Indiana University Bloomington; Deborah Diercks, M.D., University of Texas Southwestern; Russell Jones M.D., University of California, Davis; Jeph Herrin Ph.D., Yale University School of Medicine; Michel Demers; and Nilay Shah, Ph.D., Jonathan Inselman, Carlos Torres, M.D., Ph.D., Annie LeBlanc Ph.D., Ana Castaneda-Guarderas M.D., and Victor Montori, M.D., all of Mayo Clinic.

The study was funded by Patient-Centered Outcomes Research Institute and Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.

For more information: www.acc.org

Related Content

ACC 2018 highlights and trends.  #acc.18, #ACC, #ACC2018
Feature | ACC | January 31, 2018
The rapid pace of change continues to be a hallmark in cardiovascular medicine and many see that pace accelerating.
ACC 2018 Late-Breaking Trials Announced
News | ACC | January 23, 2018
Here is a list of the American College of Cardiology (ACC) 2018 annual meeting late-breaking clinical trials presente
Videos | ACC | April 03, 2017
DAIC Editor Dave Fornell takes a tour of some of the interesting new technologies from the vendor booths on the expo
ACC.17 late breaking trial presentations, ACC late-breakers,  American College of Cardiology late breaking studies
Feature | ACC | March 22, 2017
Here is a list of the American College of Cardiology (ACC) 2017 annual meeting late-breaking clinical trials presente
Siemens Sensis Vibe, hemodyanamics system

Siemens released the Sensis Vibe hemodyanamics system at ACC.16. The newer system offers better integration of cath lab data into cath lab reports and the electronic medical record (EMR).

Feature | ACC | April 25, 2016 | Jon Brubaker, MBA, RCVT, Tom Watson, BS, RCVT, and Sabrina Newell MS, RCS
There were several trends seen in new cardiovascular technologies showcased on the expo floor at the 2016 American...
Videos | ACC | April 25, 2016
MD Buyline market analyst Jon Brubaker explained the new technology and trends he saw on the show floor at ACC.16. 
Videos | ACC | April 25, 2016
Michael Jaff, M.D., medical director of Massachusetts General Hospital’s Fireman Vascular Center, explains the curren
Videos | ACC | April 15, 2016
DAIC Editor Dave Fornell takes a tour of some of the trends and interesting new technologies from the vendor booths o
Videos | ACC | April 15, 2016
MDbuyline clinical analyst Tom Watson, BS, RCVT, explains the new hemodynamic system technology trends at ACC.16.
ACC late breakers
News | ACC | February 09, 2016
The following are the late-breaking clinical trial presentations presented at the 2016 American College of Cardiology
Overlay Init