In a recent study, Keith Petrie and his colleagues in New Zealand looked at whether providing normal findings obtained with a diagnostic test would reassure patients and reduce their anxiety about symptoms before they were tested. In the investigation, patients with chest pain referred for a diagnostic exercise stress test were randomly assigned to one of three conditions: (a) standard information; (b) a pamphlet explaining the test and the meaning of normal test results; or (c) the pamphlet and a brief discussion about the meaning of normal test results. The primary outcome was the patients' reported reassurance on a 5 item scale immediately after the test and at one month later. Secondary outcomes were the proportion of patients who still had chest pain and were still taking cardiac drugs at one month. Mean levels of reassurance after testing and feedback from the doctor were significantly higher in the discussion group than in the pamphlet and standard groups, a difference maintained at one month after participating in the study. 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.
This is a nice study in that it demonstrated that if you have a chance to read information about a test and then discuss it a health care provider beforehand, you might experience fewer symptoms and require less medications after the test. As you are both a patient and health care consumer, you should be proactive in requesting this approach be taken with before you have a diagnostic test for which you have concerns.
British Medical Journal, 2007;334:352-355. Prof. Petrie’s e-mail address is: kj.petrie@auckland.ac.nz