Comparing the effectiveness of two different decision aids for stable chest discomfort

Decision aids (DAs) have been shown to increase decision quality in randomized controlled trials. This study compared the effectiveness of two different decision aids with different modes of delivery.

Patients with angiogram-proven coronary artery disease (CAD) were eligible to participate and randomly assigned to either a booklet/DVD DA or an online DA. Participants completed a survey after viewing the material that assessed patients' knowledge, treatment preferences, use of and satisfaction with the tool, and open-ended reflections on the treatment decision-making process.

Of the 62 patients screened, 34 agreed to participate and were randomly assigned to a group. Of those, 28 (15/17 booklet/DVD and 13/17 online) participants completed the survey. Patients were more likely to report reviewing all of the booklet/DVD DA compared with the online DA (60 vs. 31%, P=0.15). Knowledge scores were significantly higher in the booklet/DVD DA group than the online DA group (67 vs. 47%, P=0.018). Participants in both arms felt it was very or extremely important that doctors give patients materials like these before a catheterization (93% for booklet/DVD DA and 85% for online, P=0.54). Patients' qualitative feedback highlighted significant gaps in knowledge about treatment options, as well as a strong desire to have educational materials in advance of diagnostic catheterizations.

The pilot study suggests that both decision aids are highly valued by patients with CAD. The booklet/DVD DA was associated with higher rates of complete review and improved knowledge about the management of stable coronary disease.