Impact of an interactive video on decision making of patients with ischemic heart disease
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An experimental pilot study using repeated measures to examine the impact of an interactive video program on the decision making of patients with ischemic heart disease was carried on at a tertiary care center and a Veterans Affairs hospital. The patients (n=60, mean age 61.1 years, 77% male, 75% white, 26.7% with acute myocardial infarction), who had undergone diagnostic cardiac catheterization and were found to have significant coronary artery disease (≥75% stenosis in at least one vessel), watched the Shared Decision-Making Program (SDP) for Ischemic Heart Disease (IHD), a novel interactive video system designed to provide information necessary for patients to participate actively in decision making. This program compares medical therapy, angioplasty, and bypass surgery through a physician narrator, patient testimonials, and empirically-based, patient-specific outcome estimates of short-time complications and long-term survival. Before and after viewing the SDP, patients completed surveys containing multiple choice questions and Likert scales. They rated the program as more helpful than all other decision aids except the physician, and after viewing the SDP they expressed increased confidence in their treatment choice and decreased confidence in alternative options (p=.0001). The greatest effects appeared to be concentrated in those patients with less education (p=.04), and the program appeared to increase anxiety in nonwhite patients compared with white patients (p=0.07).
Key wordsischemic heart disease decision making patient education interactive video program
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- 1.Deber RB. Physicians in health care management, 7: The patient-physician partnership: changing roles and the desire for information. Can Med Assoc J. 1994;151(2):171–6.Google Scholar
- 4.Kasper JF, Mulley AG, Wennberg JE. Developing shared decision-making programs to improve the quality of health care. QRB. 1992;18:183–90.Google Scholar
- 11.Muhlbaier LH, Pryor DB, Rankin JS, et al. Observational comparison of event-free survival with medical and surgical therapy in patients with coronary artery disease: 20 years of follow-up. Circulation. 1982;86(5 suppl):II-198–204.Google Scholar
- 13.Cummings SR, Strull W, Nevitt MC, Hulley SB. Planning the measurements: questionnaires. In: Hulley SB, Cummings SR, eds. Designing Clinical Research. Baltimore, Md: Williams and Wilkins; 1988.Google Scholar
- 14.Rosner B. Fundamentals of Biostatistics. Belmont, Calif: Duxbury Press; 1990.Google Scholar
- 20.Deber RB. Physicians in health care management, 8: The patient-physician partnership: decision making, problem solving and the desire to participate. Can Med Assoc J. 1994;151(4):423–7.Google Scholar