Document Detail


Improving stress testing compliance following chest pain presentations to the emergency department.
MedLine Citation:
PMID:  23039293     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether a booked appointment time improves early outpatient exercise stress testing (EST) guideline adherence in patients discharged from the ED following assessment for possible acute coronary syndrome (ACS).
METHODS: In this pre and post study with a historical control group, patients classified as intermediate risk after negative ECG and serial troponin work-up for possible ACS were referred for EST. The intervention group were given an appointment time for EST at discharge, and the control group were given a referral but asked to book their own appointment. The primary outcome measure was the proportion in each group who attended for EST. Secondary outcomes were time to EST and rates of death, myocardial infarction and coronary revascularisation within 30 days in both groups. In addition, we explored reasons for non-attendance for EST for the intervention group.
RESULTS: There were 96 participants in the intervention group (mean age 55 ± 3 years) and 121 controls (mean age 62 ± 3 years). Seventy-two (75%) of the intervention group attended for EST compared with 38 (31%) of the control group, P < 0.001 after adjustment for differences in baseline variables. A poor understanding of the rationale for EST was a significant factor in patient non-attendance.
CONCLUSION: Pre-booked appointment times for EST improve timely attendance among patients discharged from the ED with intermediate-risk ACS. Compliance might improve further with patient education.
Authors:
Kevin Chung; David Playford; Stephen Pj Macdonald
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Publication Detail:
Type:  Journal Article     Date:  2012-09-02
Journal Detail:
Title:  Emergency medicine Australasia : EMA     Volume:  24     ISSN:  1742-6723     ISO Abbreviation:  Emerg Med Australas     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101199824     Medline TA:  Emerg Med Australas     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  518-24     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Affiliation:
School of Medicine, The University of Notre Dame, Fremantle.
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