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


METHODS
Single centre, non-blinded, randomised controlled trial.


METHODS
Chest pain unit of an emergency department.


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


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


METHODS
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.


BACKGROUND
Current Controlled Trials ISRCTN85248020.
Arnold
Jane
J
Northern General Hospital, Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield S5 7AU. Jane.Arnold@sth.nhs.uk
Goodacre
Steve
S
Bath
Peter
P
Price
Jonathan
J
D000208:Acute Disease; D001007:Anxiety / Q000517:prevention & control; D002637:Chest Pain / Q000209:etiology* / Q000628:therapy; D003863:Depression / Q000517:prevention & control; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D011788:Quality of Life