A randomized controlled trial of information-giving to patients referred for coronary angiography: effects on outcomes of care.
OBJECTIVE: To assess the impact of providing an educational videotape, 'Treatment Choices for Ischaemic Heart Disease: a Shared Decision-Making Program Videotape,' to patients referred for coronary angiography compared with standard patient-physician decision making (usual care). STUDY DESIGN: Randomized controlled clinical trial. SETTING: University Hospital and Veterans Affairs Hospital. PATIENTS: A consecutive sample of 217 patients referred for coronary angiography were randomized to receive 'usual care' or to receive the videotape in addition to standard patient physician decision making (videotape): 109 completed the study (50% completion rate). MAIN OUTCOME MEASURES: Knowledge of coronary artery disease, satisfaction, self-reported physical and mental health functioning, and the proportion of patients who were referred for coronary revascularization. RESULTS: Compared with patients who received 'usual care,' those who received the videotape were more knowledgeable (mean score 83 vs. 58%; P < 0.0001) but less satisfied with their treatment (79 vs. 88%; P = 0.038). There were no significant differences between the videotape and 'usual care' groups with respect to satisfaction with the decision making process (mean score 73 vs. 77%; P = 0.37), satisfaction with the decision made (mean score 73 vs. 78%; P = 0.28), physical functioning (38 vs. 38%; P = 0.76), mental health functioning (49 vs. 49%; P = 0.94), or in referral for coronary revascularization (OR 0.60; 95% CI 0.22-1.65; P = 0.33). CONCLUSION: Although the educational videotape increased patients' knowledge level, it was associated with a decrease in their level of satisfaction with treatment. Before there is wide-spread dissemination of this technology, advocates should demonstrate its effectiveness in everyday practice.
Department of Internal Medicine, University of Michigan, Ann Arbor, USA; Department of Health Management and Policy, University of Michigan, Ann Arbor, USA; Veterans Affairs Medical Center, Ann Arbor, Michigan, USA; Gerontology Program, Bowling Green State University, Bowling Green, Ohio USA; Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA.
Steven J.
SJ
Bernstein
Kimberly A.
KA
Skarupski
Carla E.
CE
Grayson
Mark R.
MR
Starling
Eric R.
ER
Bates
Kim A.
KA
Eagle