Prior information about normal test results can help reassure patients

(Effect of providing information about normal test results on patients' reassurance: randomised controlled trial)

Giving patients prior information about diagnostic tests can help improve patient outcomes and give reassurance, says a new BMJ study.

Providing reassurance is a large part of doctors' and other health professionals' roles. Yet many patients remain anxious about their condition even after the results of investigative tests come back 'normal' (i.e. the test does not reveal any particular problems).

These patients often continue to be concerned about their condition, use drugs inappropriately and seek medical help from other health professionals for their symptoms. Previous research suggests that by the time patients undergo tests they have already developed negative ideas and beliefs about their symptoms – thereby making any post-test reassurance from doctors less effective.

Researchers in New Zealand set out to analyse whether giving patients information about the meaning of normal results prior to testing would improve reassurance following medical testing.

Ninety-two patients with chest pain referred for a diagnostic exercise stress test took part in the study. They were split into three groups – the first received the normal sheet of information on the test, the second received a pamphlet, which detailed the test and included an explanation of the meaning of negative test results. The final group received the pamphlet and met with a health psychologist to discuss the test and the meaning of results before testing occurred.

Before the test, patients were asked to complete a questionnaire and rate how worried they were about their health. Patients who received a normal test result were then asked to complete another, similar, questionnaire. One month on the same patients took part in a follow-up interview.

At follow-up patients in the third group (pamphlet and discussion) reported less chest pain, were more reassured by the test and tended not to be taking cardiac drugs compared to patients in the other groups. After a month, most patients in the first group (usual information only) were not reassured by the investigation and overall reassurance was more likely to decline with time.

The authors conclude that providing patients with explanations of negative test results before the test takes place are more likely to have improved rates of reassurance and reduced the likelihood of future symptoms.