What is the clinical evidence from this study?

Study design: RCT. Population: chest pain (n=189). Intervention: Absolute cardiovascular risk counselling vs. usual care. Primary outcome: health state utilities (HSU) generated using SF-36 responses and the SF-6D's Australian tariff.

January 2, 2025BMC Health Services ResearchOpen Access

Evaluation of health-related quality of life changes in an Australian rapid access chest pain clinic

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Key result

Absolute CV risk counseling yields ~60% greater improvement in quality of life vs usual care.

n=189

Why the study?

To evaluate the impact of absolute cardiovascular risk counselling on quality-of-life indices within a chest pain clinic.

Does absolute cardiovascular risk counselling improve health-related quality of life in patients attending a rapid access chest pain clinic?

Population

189 patients attending an Australian chest pain clinic

Comparison

Absolute cardiovascular risk counselling vs usual care

Design

Prospective, open-label, blinded-endpoint randomized study

Follow-up

Minimum 12-months

Authors

JBJ. Andrew BlackUniversity of Tasmania JSJames E. SharmanPreventive Cardiology GCGang ChenMelbourne Sexual Health Centre

Discussion

Member takes

Implication

Supports integrating absolute cardiovascular risk counselling into chest pain clinics; extends RCT evidence on quality-of-life benefits.

Study Design

Type

RCT (n=189)

Blinding

open-label, blinded-endpoint

Randomization

randomised

Multicenter

Structured PICO

Does absolute cardiovascular risk counselling improve health-related quality of life in patients attending a rapid access chest pain clinic?

Population

189 adults (aged >18) presenting to a rapid access chest pain clinic with estimated 5-year absolute cardiovascular risk ≥8% and no known cardiac disease. Mean age ~60, ~72% male, Australian cohort. Excluded: known cardiac disease, pregnancy, and very high risk patients (diabetes and age >60, moderate/severe CKD, familial hypercholesterolemia, TC >7.5 mmol/L, SBP ≥180 mmHg or DBP ≥110 mmHg).

Intervention

Absolute risk-guided cardiovascular risk factor management strategy (proactive counselling regarding 5-year CV risk score, tailored strategy to improve risk score, pharmacotherapy if indicated, smoking cessation referral, and lifestyle advice by a registered nurse).

Comparator

Best practice chest pain clinic assessment (usual care) where absolute risk scores were not discussed, and individual risk factors were discussed at the treating clinician's discretion.

Outcome

Health-related quality of life measured by SF-6D health state utilities (HSU) at minimum 12-months follow-up.patient reported

Main Result

Absolute Event Rate: 0.16% vs 0.1%

Proactive absolute cardiovascular risk counselling in a rapid access chest pain clinic yields clinically meaningful improvements in patient-reported health-related quality of life compared to usual care.

Limitations

Relatively small sample sizes for stratified scores
Exploratory findings requiring a larger confirmatory study

Cite This Study

Black et al. (2025) conducted an RCT in chest pain (n=189). Absolute cardiovascular risk counselling vs. usual care was evaluated on health state utilities (HSU) generated using SF-36 responses and the SF-6D's Australian tariff. Absolute cardiovascular risk counselling in a chest pain clinic yielded clinically meaningful improvement in health-related quality of life compared to usual care (0.16 vs 0.10 utility points).

synapsesocial.com/papers/6a076fc072f0218126583cb9 https://doi.org/10.1186/s12913-024-12135-0

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Evaluation of health-related quality of life changes in an Australian rapid access chest pain clinic

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Evaluation of health-related quality of life changes in an Australian rapid access chest pain clinic

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider