Michael McGillion receives CIHR grant to develop RFA decision tool
Dr. Michael McGillion has received funding from the Canadian Institutes of Health Research (CIHR) for his proposal, “Development of a decision support tool for people with refractory angina.”
Refractory angina (RFA) is a debilitating chronic disease defined as severe chest pain that cannot be controlled by usual treatments for heart disease. The prevalence of RFA is rising as the population ages and although the annual mortality rate of patients living with RFA is unknown, it’s thought to be approximately three per cent. These individuals suffer severely impaired health-related quality of life; many have inadequate pain relief, continually revisit emergency departments for help, undergo repeated cardiac investigations, and struggle with obtaining appropriate care.
Healthcare professionals and RFA sufferers need to understand the options and implications of available treatment options in Canada, but there is no clear framework to help people understand the risks and benefits. This proposal builds on the CIHR-funded, “Joint Canadian Pain Society – Canadian Cardiovascular Society Canadian Practice Guidelines for the Management of RFA.” McGillion and his team will develop a decision support tool to help people with RFA understand their treatment options and make well-informed treatment decisions in partnership with their health care providers.
Decision-making around RFA treatment is a complex, multi-faceted endeavour. There are a number of treatment options, but none reduce cardiac pain symptoms and related disability completely. Moreover, for some treatment options, the tradeoffs of known desirable/undesirable effects are less certain than others. Several interventions with evidence of some effectiveness are invasive with varying degrees of risks and benefits. Other interventions, while less invasive, are limited in availability and/or not covered by provincial health insurance plans. Therefore, the selection of appropriate treatment must be guided not only by the probabilities of maximal symptom relief and reduced debilitation, but also by relative risks/benefits, feasibility, and patients’ values, preferences, and levels of comfort. McGillion’s decision support tool will help RFA sufferers and their care providers engage in these deliberative choices.
Posted July 13, 2011