IMPACT OF AN INTERACTIVE VIDEO ON DECISION-MAKING OF PATIENTS WITH ISCHEMIC-HEART-DISEASE

An experimental pilot study using repeated measures to examine the imp act 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 y ears, 77% male, 75% white, 26.7% with acute myocardial infarction), wh o had undergone diagnostic cardiac catheterization and were found to h ave significant coronary artery disease (greater than or equal to 75% stenosis in at least one vessel), watched the Shared Decision-Making P rogram (SDP) for Ischemic Heart Disease (IHD), a novel interactive vid eo system designed to provide information necessary for patients to pa rticipate actively in decision making. This program compares medical t herapy, 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 a nd after viewing the SDP, patients completed surveys containing multip le choice questions and Likert scales. They rated the program as more helpful than all other decision aids except the physician, and after v iewing the SDP they expressed increased confidence in their treatment choice and decreased confidence in alternative options (p = .0001). Th e 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).