TY - JOUR
T1 - Communicating acute coronary syndrome risk to women in primary care
T2 - A scoping review of the literature
AU - Knight, Elizabeth P.
AU - Slebodnik, Maribeth
AU - Pinder, Clare
AU - DeVon, Holli A.
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/12
Y1 - 2019/12
N2 - Objectives: Delay from symptom onset to hospital arrival drives poor outcomes in acute coronary syndrome (ACS), particularly for women. Primary care clinicians can discuss ACS with high-risk women, potentially reducing delay. We conducted a scoping review to assess what is known about ACS risk communication to women in primary care. Methods: We used Arksey and O'Malley's framework. The PubMed, CINAHL, PsycINFO, and Embase databases were searched for relevant articles from inception through September, 2018. No restrictions on study methodology were applied. At least two reviewers assessed each article. Articles addressing risk communication, coronary heart disease, and ACS, related to primary care settings, and including women were retained. Results: Eleven articles met inclusion criteria. Cardiovascular disease (CVD) risk communication is common in primary care; however, ACS symptoms are rarely discussed. Structured risk calculators are used to frame discussions. Communication styles include patient-centered discussions, paternalistic orders, and “scare tactics;” no single style is more effective. Analysis of gender differences in risk communication is extremely limited. Conclusion: There is scant evidence that primary care clinicians communicate effectively about ACS risk, symptoms, and appropriate symptom response. Practice implications: Interventions are needed to improve communication about ACS to at-risk women in the primary care setting.
AB - Objectives: Delay from symptom onset to hospital arrival drives poor outcomes in acute coronary syndrome (ACS), particularly for women. Primary care clinicians can discuss ACS with high-risk women, potentially reducing delay. We conducted a scoping review to assess what is known about ACS risk communication to women in primary care. Methods: We used Arksey and O'Malley's framework. The PubMed, CINAHL, PsycINFO, and Embase databases were searched for relevant articles from inception through September, 2018. No restrictions on study methodology were applied. At least two reviewers assessed each article. Articles addressing risk communication, coronary heart disease, and ACS, related to primary care settings, and including women were retained. Results: Eleven articles met inclusion criteria. Cardiovascular disease (CVD) risk communication is common in primary care; however, ACS symptoms are rarely discussed. Structured risk calculators are used to frame discussions. Communication styles include patient-centered discussions, paternalistic orders, and “scare tactics;” no single style is more effective. Analysis of gender differences in risk communication is extremely limited. Conclusion: There is scant evidence that primary care clinicians communicate effectively about ACS risk, symptoms, and appropriate symptom response. Practice implications: Interventions are needed to improve communication about ACS to at-risk women in the primary care setting.
KW - Acute coronary syndrome
KW - Primary care
KW - Risk communication
KW - Scoping review
KW - Women
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U2 - 10.1016/j.pec.2019.07.013
DO - 10.1016/j.pec.2019.07.013
M3 - Review article
C2 - 31326246
AN - SCOPUS:85069037464
SN - 0738-3991
VL - 102
SP - 2156
EP - 2161
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 12
ER -