Does Informed Consent Before Heart Procedure Actually Inform?

Many patients who have an artery-opening procedure don’t understand or remember information they receive before their surgery, and most have unrealistic expectations about what it will do for them, a new study finds.

Researchers examined the effectiveness of informed consent — which is meant to provide the risks and benefits of a procedure — given to a group of patients before they underwent percutaneous coronary intervention (PCI), also known as coronary angioplasty, a procedure that helps open up clogged arteries.

More than 40% of the patients said they did not understand or remember the information received as part of informed consent.

About 60% of those with coronary artery disease thought PCI would cure the disease, nearly 95% believed it would reduce their risk of a future heart attack, and 91% thought it would help them live longer, according to the study published Nov. 28 in the European Journal of Cardiovascular Nursing.

“These beliefs do not align with trial evidence, which shows that elective PCI is predominantly for relief of symptoms,” said study author Felicity Astin, from the University of Huddersfield in England.

The study also found that 47% of patients would have liked a family member with them when their treatment was explained, and 31% required help to understand written health information.

“Health literacy is a neglected issue. 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,” Astin said in a journal news release.

Patients and health care providers should be given enough time to discuss the proposed treatment and potential alternatives, she added.

“Patients often receive all of the information at once. They then feel overloaded, which contributes to forgetting or not comprehending what they hear,” Astin said.

Cardiologists and nurses should be trained to provide small bits of information and then ask patients to explain it in their own words to see how much they’ve understood, she suggested.

“The emphasis is on being a good teacher, not testing the patient and making them feel ashamed. But staff can only do this if they have the time — which is why patient pathways need to be configured,” Astin said.

More information

The U.S. National Heart, Lung, and Blood Institute has more on PCI.

Source: HealthDay