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

Background: Percutaneous coronary intervention is a common revascularisation technique. Serious complicationsare uncommon, but death is one of them. Seeking informed consent in advance of percutaneous coronary interventionis 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 ofcardiologists 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 similarviews on the purpose of informed consent; however, over 40% of patients and over a third of cardiologists agreed withstatements that patients do not understand, or remember, the information given to them. Patients placed less value thancardiologists on the consent process and over 60% agreed that patients depended on their doctor to make the decisionfor them. Patients’ and cardiologists’ views on the benefits of percutaneous coronary intervention were significantlydifferent; notably, 60% of patients mistakenly believed that percutaneous coronary intervention was curative. Conclusions: The percutaneous coronary intervention informed consent process requires improvement to ensurethat patients are more involved and accurately understand treatment benefits to make an informed decision. Redesignof the patient pathway is recommended to allow protected time for health professionals to engage in discussions usingevidence-based approaches such as ‘teach back’ and decision support which improve patient comprehension