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Randomized Controlled Trial
. 2025 Jan 2;25(1):8.
doi: 10.1186/s12913-024-12135-0.

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

J Andrew Black  1   2 , James E Sharman  3 , Gang Chen  4 , Andrew J Palmer  3   5 , Barbara de Graaff  3 , Mark Nelson  3 , Niamh Chapman  6 , Julie A Campbell  3
Affiliations
Randomized Controlled Trial

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

J Andrew Black et al. BMC Health Serv Res. .

Abstract

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

Data sources and study setting: Primary data was collected at the Royal Hobart Hospital, Australia, between 2014 and 2020.

Study design: Patients attending an Australian chest pain clinic were randomised into a prospective, open-label, blinded-endpoint study over a minimum 12-months follow-up.

Data collection / extraction methods: The SF-36 questionnaire was completed at baseline/follow-up and SF-6D multi-attribute utility instrument's health state utilities (HSU) were generated using SF-36 responses and the SF-6D's Australian tariff. SF-6D minimal important difference was 0.04 points. Absolute cardiovascular risk was also stratified into high/intermediate/low-risk categories for exploratory analysis of summary HSUs and dimensional scores. ANZCTR registration number 12617000615381 (registered 28/4/17).

Principal findings: Of n = 189 patients enrolled, HSUs were generated for 96% at baseline (intervention n = 93, usual care n = 88) and 61% at follow-up. There were no statistical differences in age, sex, absolute cardiovascular risk or mean HSU between groups at baseline. Summary HSUs improved more for the intervention group and the median between-group difference exceeded the minimal important difference threshold (intervention 0.16 utility points, control 0.10 utility points). For Intervention patients with high absolute risk (≥ 15%), HSU did not significantly change.

Conclusions: Absolute cardiovascular risk counselling in a chest pain clinic yielded clinically meaningful improvement in health-related quality of life.

Keywords: Absolute cardiac risk; Chest pain clinic; Cost-utility; Economic evaluation; Quality of life.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Tasmania’s Human Research Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the University of Tasmania’s Human Research Ethics Committee (approval number H0014029). Informed consent was obtained from all individual participants included in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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