Background: In 2013 over 200,000 people received Percutaneous Coronary Intervention (PCI). Obtainingvalid consent for any invasive treatment is a legal and ethical principle that reflects the right of patients todetermine what happens to their bodies and is fundamental to good practice. Patients often overestimate thebenefits of PCI, forget the risks & are not always aware of alternative treatments.Aim: To explore how the PCI consent process is understood, interpreted, experienced & practiced by patients& cardiologists & identify options for service improvement.Methods: Following ethical approval, a qualitative study was conducted, characterised by indepthinterviews& recordings of “live” consent discussions, with a purposive sample of 40 patients (36–84 years of age)referred for elective & nonprimaryPCI and 20 interventional cardiologists recruited from Northern England.Cardiologists digitally recorded consent discussions with patients; patients & doctors were interviewed 7–14days later. Research literature was used to develop topic guides used to guide interviews. Data analysis: Datacollection & analysis took place simultaneously in keeping with grounded theory techniques. Emerging conceptswere explored in depth across participants & settings. NVivo (version 10) supported data coding, management& retrieval. All interviews were audio recorded & transcribed. A team of researchers independently codedtranscripts to support the trustworthiness of findings.Results: 4 themes emerged from the analysis: (i) the patientdoctorrelationship, (ii) influences on decisionmaking, (iii) delivering & interpreting risk information, (iv) expectations of treatment. Service delivery patternsdiffered across sites with regard to the time period between consent & procedure & the individual who tookconsent. Despite such differences all patients reported feeling well informed. The consent discussion did notappear to influence patients' decisions to proceed with treatment; the majority had made the decision to havePCI treatment as soon as they were told they needed it.Conclusion: Findings illuminate the experiences of individuals from 2 settings in Northern England; the consentdiscussion represented one stage in a two way process of information exchange between patient & cardiologist.Patients valued information about their treatment but were generally content for cardiologists to make treatmentdecisions for them & undergo whatever treatment would make them well. The consent discussion functioned asan information clarification process for patients who had already decided to undergo treatment.
Probyn, JE., Greenhalgh, J., Conway, D., Morton, AC., Holt, J., Marshall, K., ... Astin, F. (2015). Experiences of informed consent for percutaneous coronary intervention: an interview study. European Heart Journal, 36(S1), 125-125. [P774].