Percutaneous Coronary Intervention: An informed consent that is hardly understood

Many heart patients do not understand or remember the information provided before procedures. For example, patients mistakenly believe that Percutaneous Coronary Intervention cures them of heart disease.

Most patients overestimate the benefits of the procedure

Most heart patients do not understand or remember the information that is provided to them before procedures. For example, many patients mistakenly believe that Percutaneous Coronary Intervention (PCI) cures them of heart disease. This is one of the results of an informed consent study published in the European Journal of Cardiovascular Nursing.

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Informed consent involves providing the patient with all the details of a medical or surgical procedure, including the risks and benefits. It is a legal and ethical requirement through which the patient expresses his or her willingness to undergo a procedure. Patients should receive sufficient information to make a valid choice. Healthcare professionals should also confirm that the patient has sufficient psychological capacity to make a decision at that time.

A recent UK study found that more than 40% of patients do not understand or remember the information received about PCI, one of the most common procedures in high and middle-income countries.

The group of patients included in the study was treated with elective or urgent PCI, but not emergency PCI. Approximately 60% of patients with coronary heart disease who undergo elective intervention PCI think that the intervention can cure coronary heart disease. Almost all patients (95%) think it reduces the risk of a future heart attack and 91% think it increases their life span.

"These beliefs are not in line with scientific evidence. Elective angioplasty is primarily used to relieve symptoms," said study author Professor Felicity Astin of the University of Huddersfield, UK.

According to Prof. Astin, health services should be reconfigured to give patients and physicians enough time to discuss the proposed treatment and potential alternatives. She explained: "Patients often receive all the information at the same time. They are at risk of getting confused, which contributes to forgetting or not understanding what they feel". Almost half of the respondents (47%) would have liked a family member with them when informed consent was signed. Almost a third (31%) of the patients in the study needed help to understand the written text they had to sign.

Prof. Astin added: "Health literacy is a neglected issue. Information leaflets and the text of the documents to sign should be in simple language. In addition, physicians should ask patients if they need help reading or understanding health information".

The study highlights the need for patients and health professionals to work together to develop and evaluate new approaches to information sharing and decision-making in medical settings and procedures.

Source: 
Astin F, Stephenson J, Probyn J, Holt J, Marshall K, Conway D. Cardiologists' and patients' views about the informed consent process and their understanding of the anticipated treatment benefits of coronary angioplasty: a survey study. Eur J Cardiovasc Nurs. 2019 Nov 27:1474515119879050. doi: 10.1177/1474515119879050. ESC Press Office. Informed consent for heart procedure: most patients overestimate benefits. 25/11/2019

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