Related Experiment Video
Updated: Apr 23, 2026
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
An intervention to reassure patients about test results in rapid access chest pain clinic: a pilot randomised
Kathryn Hicks1, Kim Cocks, Belen Corbacho Martin
1Department of Health Sciences, York Trials Unit, University of York, York YO10 5DD, UK. kate.hicks@york.ac.uk.
Insights
A nurse-led discussion before cardiac testing did not increase patient reassurance compared to a pamphlet alone. This pilot study suggests further large-scale trials of this intervention are not needed.
Area of Science:
- Cardiology
- Psychology
- Health Services Research
Background:
- Many patients presenting to chest pain clinics have non-cardiac pain.
- Current guidelines favor medication over revascularization for stable coronary heart disease, potentially leaving patients uncertain about their diagnosis and treatment.
- Previous research indicated psychological discussions could improve reassurance in patients with non-cardiac chest pain.
Purpose of the Study:
- To pilot study procedures and inform sample size for a future multi-center trial.
- To estimate the effectiveness of a nurse-led discussion intervention on patient reassurance.
- To assess the feasibility of a randomized controlled trial in a rapid access chest pain clinic setting.
Main Methods:
- A two-arm pilot randomized controlled trial involving 120 participants with new-onset, non-urgent chest pain.
- Participants were randomized to receive either a pre-test discussion with a nurse plus a pamphlet, or the pamphlet alone.
- Primary outcomes included recruitment rate, feasibility, and patient-reported reassurance scores at one and six months.
Main Results:
- 44% (120/270) of eligible patients were randomized.
- No significant difference in mean reassurance scores was observed between the discussion and pamphlet arms at one month (34.2 vs 33.7) or six months (35.3 vs 35.9).
- Patient-reported chest pain and heart medication use were similar between the groups.
Conclusions:
- A larger trial of the nurse-led discussion intervention is not warranted.
- Patients reported high levels of reassurance, irrespective of receiving the discussion or the pamphlet alone.
- The findings suggest that standard pre-test information may be sufficient for reassuring patients in this setting.
Background:
Most people referred to rapid access chest pain clinics have non-cardiac chest pain, and in those diagnosed with stable coronary heart disease, guidance recommends that first-line treatment is usually medication rather than revascularisation. Consequently, many patients are not reassured they have the correct diagnosis or treatment. A previous trial reported that, in people with non-cardiac chest pain, a brief discussion with a health psychologist before the tests about the meaning of potential results led to people being significantly more reassured. The aim of this pilot was to test study procedures and inform sample size for a future multi-centre trial and to gain initial estimates of effectiveness of the discussion intervention.
Methods:
This was a two-arm pilot randomised controlled trial in outpatient rapid access chest pain clinic in 120 people undergoing investigation for new onset, non-urgent chest pain. Eligible participants were randomised to receive either: a discussion about the meaning and implication of test results, delivered by a nurse before tests in clinic, plus a pre-test pamphlet covering the same information (Discussion arm) or the pre-test pamphlet alone (Pamphlet arm). Main outcome measures were recruitment rate and feasibility for a future multi-centre trial, with an estimate of reassurance in the groups at month 1 and 6 using a 5-item patient-reported scale.
Results:
Two hundred and seventy people attended rapid access chest pain clinic during recruitment and 120/270 participants (44%) were randomised, 60 to each arm. There was no evidence of a difference between the Discussion and Pamphlet arms in the mean reassurance score at month 1 (34.2 vs 33.7) or at month 6 (35.3 vs 35.9). Patient-reported chest pain and use of heart medications were also similar between the two arms.
Conclusions:
A larger trial of the discussion intervention in the UK would not be warranted. Patients reported high levels of reassurance which were similar in patients receiving the discussion with a nurse and in those receiving a pamphlet alone.
Trial Registration:
Current Controlled Trials ISRCTN60618114 (assigned 27.05.2011).
More Related Videos
06:28E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
10:28Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Related Concept Videos
01:29Angina III: Clinical Manifestations and Assessment
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:27Coronary Artery Disease V: Interprofessional Care
01:20Angina V: Nursing Management
01:30Acute Coronary Syndrome III: Diagnostic Studies