Implementation of a health-literate patient decision aid for chest pain in the emergency department |
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| Affiliation: | 1. University of Arkansas for Medical Sciences, Center for Health Literacy, Little Rock, AR 72205-7199 USA;2. University of Arkansas for Medical Sciences, Department of Emergency Medicine, Little Rock, AR 72205-7199 USA;1. Department of Peadiatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;2. Department of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;1. University of Utah, Department of Biomedical Informatics, 421 Wakara Way, Salt Lake City, UT, 84132, USA;2. University of Utah, Department of Geriatrics, Salt Lake City, USA;3. Harvard University, Division of General Internal Medicine and Primary Care, Boston, USA;4. University of Utah, Division of Clinical Epidemiology, Salt Lake City, USA;1. Department of Medicine, University of Washington, Seattle, WA, USA;2. The Evergreen State College, Olympia, WA, USA;3. David Geffen School of Medicine at UCLA, Los Angeles, CA, USA |
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| Abstract: | ObjectiveThe aim of this study was to investigate the implementation of a new health-literacy-tested patient decision aid for chest pain in Emergency Department (ED) patients. Outcomes included disposition, knowledge, decisional conflict and satisfaction prior to discharge. Patient health literacy was explored as a factor that may explain disparities in sub-group analysis of all outcomes.MethodsA health-literacy adapted tool was deployed using a pre/post intervention design. Patients enrolled during the intervention period were given the adapted chest pain decision aid that was used in conversation with their emergency medicine physician to decide on their course of action prior to being discharged.ResultsA total of 169 participants were surveyed and used in the final analysis. Patients in the usual care group were 2.6 times more likely to be admitted for chest pain than patients in the intervention group. Knowledge scores were higher in the intervention group, while no significant differences were observed in decisional conflict and patient satisfaction, or by patient health literacy level.Conclusion and practice implicationsUsing the adapted chest pain decision tool in emergency medicine may improve knowledge and reduce admissions, while addressing known barriers to understanding related to patient health literacy. |
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| Keywords: | Health literacy Chest pain Decision aid Emergency department |
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