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Development and testing of innovative patient resources for the management of coronary heart disease (CHD): a
Julie Redfern1, Elizabeth Ellis, Tom Briffa
1School of Physiotherapy, University of Sydney, Sydney, Australia. julieredfern@dodo.com.au
Insights
New patient leaflets for coronary heart disease (CHD) secondary prevention were developed and tested. These resources empower patients by supporting shared decision-making for managing risk factors like cholesterol and blood pressure.
Area of Science:
- Cardiology
- Public Health
- Health Communication
Background:
- Coronary heart disease (CHD) is a leading cause of death, yet many patients do not engage in rehabilitation.
- Existing resources often lack patient-centered design, hindering choice and decision-making in secondary prevention.
- There is a need for improved patient resources to facilitate active participation in managing CHD risk factors.
Purpose of the Study:
- To develop and evaluate a series of risk factor modules and patient information leaflets for secondary prevention of CHD.
- To enhance patient choice and decision-making in managing cardiovascular risk factors.
- To create resources that are high-quality, readable, and suitable for patients with CHD.
Main Methods:
- A three-phase approach was employed, starting with literature review and health professional interviews to identify risk factors and management options.
- Patient information leaflets were developed based on published guidelines and input from individuals with CHD.
- Leaflets underwent rigorous testing for quality (DISCERN), readability (Flesch), and suitability (SAM), and were compared against existing cardiac rehabilitation materials.
Main Results:
- Four primary risk factors were identified: cholesterol, blood pressure, smoking, and physical inactivity, with various management options provided.
- Developed leaflets achieved high DISCERN quality scores (59-62/80) and a Flesch readability score of 75 ('fairly easy to read').
- Leaflets were rated highly for suitability, ease of understanding, usefulness, and motivation, outperforming existing cardiac rehabilitation leaflets.
Conclusions:
- A progressive, three-phase development process successfully created and validated risk factor modules and patient information leaflets.
- These patient-centered leaflets are poised to enhance shared decision-making and patient empowerment in the management of CHD.
- The developed resources offer a valuable tool for improving secondary prevention strategies for individuals with coronary heart disease.
Background:
Although heart disease is a major cause of morbidity and mortality the majority of patients do not access existing rehabilitation programs and patient resources are not designed to facilitate patient choice and decision-making. The objective of this study was to develop and test a series of risk factor modules and corresponding patient information leaflets for secondary prevention of CHD.
Methods:
In phase one, a series of risk factor modules and management options were developed following analysis of literature and interviews with health professionals. In phase two, module information leaflets were developed using published guidelines and interviews of people with CHD. In phase three, the leaflets were tested for quality (DISCERN), readability (Flesch) and suitability (SAM) and were compared to the existing cardiac rehabilitation (CR) information leaflet. Finally, the patients assessed the leaflets for content and relevance.
Results:
Four key risk factors identified were cholesterol, blood pressure, smoking and physical inactivity. Choice management options were selected for each risk factor and included medical consultation, intensive health professional led program, home program and self direction. Patient information needs were then identified and leaflets were developed. DISCERN quality scores were high for cholesterol (62/80), blood pressure (59/80), smoking (62/80) and physical activity (62/80), all scoring 4/5 for overall rating. The mean Flesch readability score was 75, representing "fairly easy to read", all leaflets scored in the superior category for suitability and were reported to be easy to understand, useful and motivating by persons with CHD risk factors. The developed leaflets scored higher on each assessment than the existing CR leaflets.
Conclusion:
Using a progressive three phase approach, a series of risk factor modules and information leaflets were successfully developed and tested. The leaflets will contribute to shared-decision making and empowerment for persons with CHD.
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