Education on cardiac risk and CPR in cardiology clinic waiting rooms: a randomised clinical trial

Abstract

ObjectiveWaiting time is inevitable during cardiovascular (CV) care. This study examines whether waiting room-based CV education could complement CV care.MethodsA 2:1 randomised clinical trial of patients in waiting rooms of hospital cardiology clinics. Intervention participants received a series of tablet-delivered CV educational videos and were randomised 1:1 to receive another video on cardiopulmonary resuscitation (CPR) or no extra video. Control received usual care. The primary outcome was the proportion of participants reporting high motivation to improve CV risk-modifying behaviours (physical activity, diet and blood pressure monitoring) post-clinic. Secondary outcomes: clinic satisfaction, CV lifestyle risk factors (RFs) and confidence to perform CPR. Assessors were blinded to treatment allocation.ResultsAmong 514 screened, 330 were randomised (n=220 intervention, n=110 control) between December 2018 and March 2020, mean age 53.8 (SD 15.2), 55.2% male. Post-clinic, more intervention participants reported high motivation to improve CV risk-modifying behaviours: 29.6% (64/216) versus 18.7% (20/107), relative risk (RR) 1.63 (95% CI 1.04 to 2.55). Intervention participants reported higher clinic satisfaction RR: 2.19 (95% CI 1.45 to 3.33). Participants that received the CPR video (n=110) reported greater confidence to perform CPR, RR 1.61 (95% CI 1.20 to 2.16). Overall, the proportion of participants reporting optimal CV RFs increased between baseline and 30-day follow-up (16.1% vs 24.8%, OR=2.44 (95% CI 1.38 to 4.49)), but there was no significant between-group difference at 30 days.ConclusionCV education delivery in the waiting room is a scalable concept and may be beneficial to CV care. Larger studies could explore its impact on clinical outcomes.Trial registration numberANZCTR12618001725257.

Impact of Socio-demographic Characteristics on Time in Outpatient Cardiology Clinics: A Retrospective Analysis

“…Potential implications of these findings include consideration of a more productive use of this time in ambulatory clinics, such as implementing interventions during this time that can improve health literacy and may improve health outcomes and satisfaction with health services. 25,26…”

“…Potential implications of these findings include consideration of a more productive use of this time in ambulatory clinics, such as implementing interventions during this time that can improve health literacy and may improve health outcomes and satisfaction with health services. 25,26 The interaction between SES and time to accessing health services has been debated for over 20 years. Most data are derived from elective surgery waiting lists, 13,27 and there is some evidence discrimination is reversing as new policies are introduced.…”

Information Needs and Communication Strategies for People with Coronary Heart Disease: A Scoping Review

“…Visual communication aides such as images, videos and heart models may be an effective delivery technique [38,66,[75][76][77]. Patients prefer positive images that are colourful and engaged with text, and images of real people rather than cartoons [76].…”

“…Visual communication is also successfully used across digital platforms. For example, greater patient satisfaction was reported when receiving SMS text messages that included a visual aide [76], and tablet-delivered waiting room education increased motivation to improve cardiovascular health-related behaviours [77].…”

Heartbeat: health literacy for improving cardiac outcomes

“…The potential impact of patient education on improving outcomes in patients with cardiovascular disease (CVD) has received little attention. In a randomised clinical trial, McIntyre and colleagues 1 found that waiting room video-based education about CVD risk reduction resulted in more patients being motivated to implement heart healthy behaviours (29.6% vs 18.7%, relative risk 1.63, 95% CI 1.04 to 2.55) and higher levels of satisfaction with the clinic visit. Participants who were also randomised to receive education about cardio-pulmonary resuscitation (CPR) reported greater confidence in performing CPR.…”