Impact of a Decision Aid on Patient Decision Making in Emergency Department Chest Pain Patients

Mayo Clinic204 enrolled

Overview

We are doing a study to assess the impact of including patients in making decision regarding their own medical care in the emergency department. We will randomly assign them to either receive a decision aid or usual care. In doing this, we aim to increase patient satisfaction and safely decrease medical cost.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Enrollment

204

Conditions

Acute Coronary Syndrome

Interventions

Decision AidOTHER

Chest pain choice decision aid

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults with a primary complaint of chest pain. * Treating clinician's next consideration is observation unit admission for cardiac stress testing. Exclusion Criteria: * Initial cardiac troponin T value \>99th percentile (\>0.01ng/mL) * History of coronary artery disease * coronary revascularization procedure within the previous 30 days * cocaine use within 72 hours by the clinician's initial history * pregnancy * patient cannot read English or have, in their clinician's judgment, major learning barriers, such as visual or hearing impairment or dementia that would compromise their ability to give written informed consent (or use the decision aid)

Locations (1)

Mayo Clinic Rochester

Rochester, Minnesota, United States

Outcomes

Primary Outcomes

Patient knowledge

Patient knowledge regarding their short-term risk for an ACS and the risks of radiation exposure.

Time frame: Immediately after patient visit

Secondary Outcomes

Quality of decision making process

Quality of the decision making process for the patient and clinician

Time frame: Immediately after patient visit

Satisfaction with decision aid

Patient and clinician acceptability and satisfaction with the decision aid

Time frame: Immediately after patient visit

Proportion of patients who decided to undergo observation unit admission and urgent cardiac stress testing

Time frame: During the initial ED visit

Delayed or missed ACS

Rate of delayed or missed ACS

Time frame: 30 days

Economic costs and healthcare utilization

Time frame: 30 days

Data from ClinicalTrials.gov

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