Cardiologists' and patients' views about the informed consent process and their understanding of the anticipated treatment benefits of coronary angioplasty : a survey study

Astin, F; Stephenson, J; Probyn, JE; Holt, J; Marshall, K; Conway, D

Abstract

Background: Percutaneous coronary intervention is a common revascularisation technique. Serious complications
are uncommon, but death is one of them. Seeking informed consent in advance of percutaneous coronary intervention
is mandatory. Research shows that percutaneous coronary intervention patients have inaccurate perceptions of risks,
benefits and alternative treatments.

Aim: To assess cardiologists’ and patients’ views about the informed consent process and anticipated treatment benefits.

Methods: Two cross-sectional, anonymous surveys were distributed in England: an electronic version to a sample of
cardiologists and a paper-based version to patients recruited from 10 centres.

Results: A sample of 118 cardiologists and 326 patients completed the surveys. Cardiologists and patients shared similar
views on the purpose of informed consent; however, over 40% of patients and over a third of cardiologists agreed with
statements that patients do not understand, or remember, the information given to them. Patients placed less value than
cardiologists on the consent process and over 60% agreed that patients depended on their doctor to make the decision
for them. Patients’ and cardiologists’ views on the benefits of percutaneous coronary intervention were significantly
different; notably, 60% of patients mistakenly believed that percutaneous coronary intervention was curative.

Conclusions: The percutaneous coronary intervention informed consent process requires improvement to ensure
that patients are more involved and accurately understand treatment benefits to make an informed decision. Redesign
of the patient pathway is recommended to allow protected time for health professionals to engage in discussions using
evidence-based approaches such as ‘teach back’ and decision support which improve patient comprehension.

• Journal Article Type: Article
• Acceptance Date: Sep 8, 2019
• Online Publication Date: Nov 27, 2019
• Publication Date: Mar 1, 2020
• Deposit Date: Nov 28, 2019
• Publicly Available Date: Nov 28, 2019
• Journal: European Journal of Cardiovascular Nursing
• Print ISSN: 1474-5151
• Electronic ISSN: 1873-1953
• Publisher: SAGE Publications
• Volume: 19
• Issue: 3
• Pages: 260-268
• DOI: https://doi.org/10.1177/1474515119879050
• Publisher URL: https://doi.org/10.1177/1474515119879050
• Related Public URLs: https://journals.sagepub.com/home/cnu
• Additional Information: Projects : Informed consent for percutaneous coronary intervention: An exploratory study