Optimizing informed consent for percutaneous coronary intervention

a mixed methods study

Felicity Astin, J Probyn, D Conway, J Greenhalgh, J Holt, K Marshall, J Wright

Research output: Contribution to journalMeeting Abstract

Abstract

Background: Percutaneous coronary intervention (PCI) is a common treatment to vascularise myocardial muscle.1 Serious complication
are uncommon, but death is one of them. Doctors must obtain consent before doing PCI; for this to be sound the patient
must be mentally able, act of their own free will, and be given enough information to help their decision making. Obtaining valid
consent is a legal and ethical requirement. However, published studies tell us that the amount and quality of information given
to PCI patients is variable; benefits are often overestimated, risks forgotten and alternative treatments not always considered.
Patients may not be informed in the way that they should be.
Patients and Methods: In this mixed methods study, we aimed to describe the PCI informed consent process and survey the
attitudes of patients and cardiologists about informed consent in England. We conducted in-depth interviews with 41 patients,
19 cardiologists, and recorded 37 consent conversations at two hospitals. We also sent questionnaires to 326 patients and 124
cardiologists recruited across England to find out their views on consent.
Results: Patients were mostly satisfied with the PCI consent process, valued cardiologists as the ‘experts’, and saw PCI as a ‘fix’
for their heart condition. The informed consent process was seen as ‘paperwork’ that was not especially important, but necessary
to get access to treatment. Most patients (81%) received written information before PCI and had (94%) signed the consent
form on the day of treatment. Patients were not very concerned by this; most (81%) reported being highly satisfied by the explanation
they got. The benefits of PCI were overestimated, most (89%) wanted information about all risks, fewer (84%) were interested
in knowing about alternative treatments or what would happen if they did not have PCI.
Conclusion: Patients and cardiologists were generally satisfied with the PCI consent process, but the reality of practice does not
fully mirror practice recommendations in England.
Original languageEnglish
Article number586
Number of pages1
JournalCardiologia Croatica
Volume11
Issue number(10-11)
DOIs
Publication statusPublished - 31 Oct 2016
Event11th Congress of the Croatian Cardiac Society with international participation / 6th Congress of the Croatian Association of Cardiology Nurses - Zagreb, Croatia
Duration: 3 Nov 20166 Nov 2016
Conference number: 11

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Percutaneous Coronary Intervention
Informed Consent
England
Therapeutics
Personal Autonomy
Decision Making
Interviews
Cardiologists

Cite this

Astin, F., Probyn, J., Conway, D., Greenhalgh, J., Holt, J., Marshall, K., & Wright, J. (2016). Optimizing informed consent for percutaneous coronary intervention: a mixed methods study. Cardiologia Croatica, 11((10-11)), [586]. https://doi.org/10.15836/ccar2016.586
Astin, Felicity ; Probyn, J ; Conway, D ; Greenhalgh, J ; Holt, J ; Marshall, K ; Wright, J. / Optimizing informed consent for percutaneous coronary intervention : a mixed methods study. In: Cardiologia Croatica. 2016 ; Vol. 11, No. (10-11).
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abstract = "Background: Percutaneous coronary intervention (PCI) is a common treatment to vascularise myocardial muscle.1 Serious complicationare uncommon, but death is one of them. Doctors must obtain consent before doing PCI; for this to be sound the patientmust be mentally able, act of their own free will, and be given enough information to help their decision making. Obtaining validconsent is a legal and ethical requirement. However, published studies tell us that the amount and quality of information givento PCI patients is variable; benefits are often overestimated, risks forgotten and alternative treatments not always considered.Patients may not be informed in the way that they should be.Patients and Methods: In this mixed methods study, we aimed to describe the PCI informed consent process and survey theattitudes of patients and cardiologists about informed consent in England. We conducted in-depth interviews with 41 patients,19 cardiologists, and recorded 37 consent conversations at two hospitals. We also sent questionnaires to 326 patients and 124cardiologists recruited across England to find out their views on consent.Results: Patients were mostly satisfied with the PCI consent process, valued cardiologists as the ‘experts’, and saw PCI as a ‘fix’for their heart condition. The informed consent process was seen as ‘paperwork’ that was not especially important, but necessaryto get access to treatment. Most patients (81{\%}) received written information before PCI and had (94{\%}) signed the consentform on the day of treatment. Patients were not very concerned by this; most (81{\%}) reported being highly satisfied by the explanationthey got. The benefits of PCI were overestimated, most (89{\%}) wanted information about all risks, fewer (84{\%}) were interestedin knowing about alternative treatments or what would happen if they did not have PCI.Conclusion: Patients and cardiologists were generally satisfied with the PCI consent process, but the reality of practice does notfully mirror practice recommendations in England.",
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Astin, F, Probyn, J, Conway, D, Greenhalgh, J, Holt, J, Marshall, K & Wright, J 2016, 'Optimizing informed consent for percutaneous coronary intervention: a mixed methods study', Cardiologia Croatica, vol. 11, no. (10-11), 586. https://doi.org/10.15836/ccar2016.586

Optimizing informed consent for percutaneous coronary intervention : a mixed methods study. / Astin, Felicity; Probyn, J; Conway, D; Greenhalgh, J; Holt, J; Marshall, K; Wright, J.

In: Cardiologia Croatica, Vol. 11, No. (10-11), 586, 31.10.2016.

Research output: Contribution to journalMeeting Abstract

TY - JOUR

T1 - Optimizing informed consent for percutaneous coronary intervention

T2 - a mixed methods study

AU - Astin, Felicity

AU - Probyn, J

AU - Conway, D

AU - Greenhalgh, J

AU - Holt, J

AU - Marshall, K

AU - Wright, J

PY - 2016/10/31

Y1 - 2016/10/31

N2 - Background: Percutaneous coronary intervention (PCI) is a common treatment to vascularise myocardial muscle.1 Serious complicationare uncommon, but death is one of them. Doctors must obtain consent before doing PCI; for this to be sound the patientmust be mentally able, act of their own free will, and be given enough information to help their decision making. Obtaining validconsent is a legal and ethical requirement. However, published studies tell us that the amount and quality of information givento PCI patients is variable; benefits are often overestimated, risks forgotten and alternative treatments not always considered.Patients may not be informed in the way that they should be.Patients and Methods: In this mixed methods study, we aimed to describe the PCI informed consent process and survey theattitudes of patients and cardiologists about informed consent in England. We conducted in-depth interviews with 41 patients,19 cardiologists, and recorded 37 consent conversations at two hospitals. We also sent questionnaires to 326 patients and 124cardiologists recruited across England to find out their views on consent.Results: Patients were mostly satisfied with the PCI consent process, valued cardiologists as the ‘experts’, and saw PCI as a ‘fix’for their heart condition. The informed consent process was seen as ‘paperwork’ that was not especially important, but necessaryto get access to treatment. Most patients (81%) received written information before PCI and had (94%) signed the consentform on the day of treatment. Patients were not very concerned by this; most (81%) reported being highly satisfied by the explanationthey got. The benefits of PCI were overestimated, most (89%) wanted information about all risks, fewer (84%) were interestedin knowing about alternative treatments or what would happen if they did not have PCI.Conclusion: Patients and cardiologists were generally satisfied with the PCI consent process, but the reality of practice does notfully mirror practice recommendations in England.

AB - Background: Percutaneous coronary intervention (PCI) is a common treatment to vascularise myocardial muscle.1 Serious complicationare uncommon, but death is one of them. Doctors must obtain consent before doing PCI; for this to be sound the patientmust be mentally able, act of their own free will, and be given enough information to help their decision making. Obtaining validconsent is a legal and ethical requirement. However, published studies tell us that the amount and quality of information givento PCI patients is variable; benefits are often overestimated, risks forgotten and alternative treatments not always considered.Patients may not be informed in the way that they should be.Patients and Methods: In this mixed methods study, we aimed to describe the PCI informed consent process and survey theattitudes of patients and cardiologists about informed consent in England. We conducted in-depth interviews with 41 patients,19 cardiologists, and recorded 37 consent conversations at two hospitals. We also sent questionnaires to 326 patients and 124cardiologists recruited across England to find out their views on consent.Results: Patients were mostly satisfied with the PCI consent process, valued cardiologists as the ‘experts’, and saw PCI as a ‘fix’for their heart condition. The informed consent process was seen as ‘paperwork’ that was not especially important, but necessaryto get access to treatment. Most patients (81%) received written information before PCI and had (94%) signed the consentform on the day of treatment. Patients were not very concerned by this; most (81%) reported being highly satisfied by the explanationthey got. The benefits of PCI were overestimated, most (89%) wanted information about all risks, fewer (84%) were interestedin knowing about alternative treatments or what would happen if they did not have PCI.Conclusion: Patients and cardiologists were generally satisfied with the PCI consent process, but the reality of practice does notfully mirror practice recommendations in England.

KW - informed consent

KW - percutaneous coronary intervention

U2 - 10.15836/ccar2016.586

DO - 10.15836/ccar2016.586

M3 - Meeting Abstract

VL - 11

JO - Cardiologia Croatica

JF - Cardiologia Croatica

SN - 1848-543X

IS - (10-11)

M1 - 586

ER -