BMJ  2007;334:352 (17 February), doi:10.1136/bmj.39093.464190.55 (published 26 January 2007)

Research

Effect of providing information about normal test results on patients' reassurance: randomised controlled trial

¹ Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, New Zealand, ² Department of Cardiology, Auckland City Hospital, ³ Philipps-University, Faculty of Psychology, Marburg, Germany

Objective To investigate whether providing information about normal findings before a diagnostic test improves patients' reassurance and reduces anxiety about symptoms.

Design Randomised controlled trial.

Setting Outpatient cardiology clinic.

Participants 92 patients with chest pain referred for a diagnostic exercise stress test.

Intervention Before undergoing testing patients were randomised to receive standard information (n=28; control group), a pamphlet explaining the function of the test and the meaning of normal test results (n=30; pamphlet group), or the pamphlet and a brief discussion about the meaning of normal test results (n=34; discussion group).

Main outcome measures The primary outcome was patients' reported reassurance on a 5 item scale immediately after the test and at one month. Secondary outcomes were the proportion of patients still with chest pain and still taking cardiac drugs at one month.

Results The mean levels of reassurance after testing and feedback from the doctor were significantly higher in the discussion group (42.0, 95% confidence interval 39.7 to 44.2) than in the pamphlet (39.2, 36.1 to 42.3) and control groups (35.8, 31.6 to 39.9). This difference was maintained at one month. The proportion of patients still reporting chest pain at one month decreased significantly in the discussion group (to 17%) and pamphlet group (to 28%) but not in the control group (to 36%). A trend was for fewer patients in the discussion group to be taking cardiac drugs at one month.

Conclusion Providing patients with information about normal test results before testing can improve rates of reassurance and reduce the likelihood of future reports of chest pain.

Trial registration Current Controlled Trials ISRCTN87589121 [controlled-trials.com] .

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This article has been cited by other articles:

• Arnold, J., Goodacre, S., Bath, P., Price, J. (2009). Information sheets for patients with acute chest pain: randomised controlled trial. BMJ 338: b541-b541 [Abstract] [Full text]  
• Hatcher, S., Arroll, B. (2008). Assessment and management of medically unexplained symptoms. BMJ 336: 1124-1128 [Full text]  
• Rubin, G J., Page, L., Morgan, O., Pinder, R. J, Riley, P., Hatch, S., Maguire, H., Catchpole, M., Simpson, J., Wessely, S. (2007). Public information needs after the poisoning of Alexander Litvinenko with polonium-210 in London: cross sectional telephone survey and qualitative analysis. BMJ 335: 1143-1143 [Abstract] [Full text]  
• (2007). Explaining Normal Test Results Before Testing May Reassure Patients. JWatch Emergency Med. 2007: 4-4 [Full text]  
• Penzien, D. B, Rains, J. C (2007). Reassuring patients about normal test results. BMJ 334: 325-325 [Full text]  

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Should the value of written information be explored further?

Satyamurthy Anuradha, et al.
bmj.com, 20 Feb 2007 [Full text]

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