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Patients may not understand informed consent process before PCI
Discrepancies in understanding the informed consent process before PCI among patients and cardiologists showed that improvements are needed for patients to make an informed decision regarding revascularization, according to a study published in the European Journal of Cardiovascular Nursing.
“Health literacy is a neglected issue,” Felicity Astin, PhD, professor of nursing and applied health research at the Centre for Applied Research in Health at University of Huddersfield in England, said in a press release. “Leaflets should be in plain language. In addition, clinicians should ask patients if they need help reading or understanding health information. Patients will not volunteer that they can’t read.”
Researchers analyzed data from questionnaires completed by 118 cardiologists who are involved in taking informed consent for PCI and 326 patients (mean age, 67 years; 75% men) who were treated with acute or elective PCI in England. Surveys were conducted to collect responses on informed consent including attitudes, the purpose and views of the process.
The majority of patients and cardiologists understood that the informed consent process was meant to help understand the benefits (91% acute PCI; 92% elective PCI; 95% cardiologists), risks and complications (97% acute PCI; 97% elective PCI, 100% cardiologists) of PCI.
Despite understanding the process, 66% of patients agreed that they depended on their doctor to make the decision. There were also patients who reported not understanding (54% acute PCI; 41% elective PCI) or remembering (67% acute PCI; 56% elective PCI) the information given to them. For cardiologists, 34% agreed that their patients do not understand the information and that 53% believe that their patients do not remember what was provided to them.
Sixty percent of patients who underwent acute or elective PCI believed that PCI would cure CHD. In contrast, 2% of cardiologists believed that PCI would cure CHD, 12% said it would reduce the risk for acute MI and 3% believed that PCI would prolong life span.
“Redesign of the patient pathway is recommended to allow protected time for health professionals to engage in discussions with patients and those close to them using evidence-based approaches such as ‘teach back’ and decision support to improve patient comprehension,” Astin and colleagues wrote. – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.