Patient Experience of Informed Consent for Diagnostic Coronary Angiogram and Follow-On Treatments

Background/Aims: Coronary angiography requires a complex informed consent process, a legal and ethical requirement before treatment, which may allow percutaneous coronary intervention (PCI) to be completed as a continuation of a coronary angiography. Patients are routinely consented for both interventions, but over a quarter will only receive diagnostic angiogram. Therefore, the specific aim of this study is to describe patients’ demography, views and understanding of the informed consent process, in patients who gave informed consent for coronary angiography and same setting PCI but were found to be ineligible for same setting PCI.
Methods: A descriptive cross sectional survey design was used to explore these patients’ views. Participants completed a 36-item survey on the day after diagnostic coronary angiography.
Results: Data was collected from a convenience sample of 62 subjects, 73% male, 68% college educated, 40% working with a mean age of 68.4 (11.4) years. Women reported; greater difficulty in recalling treatment information (p<.03) found discussions about alternative treatments more confusing (p<.02), and the disclosure of comprehensive risk information a deterrent to consent 2 for treatment (p<.02), when compared to men. Higher levels of education were associated with greater preference for information and involvement in treatment decisions (p<.002).
Conclusions: Patients who participate in an informed consent for diagnostic coronary angiography with, or without, a same-setting PCI need clear comprehensive information on alternatives. Recognizing patient’s need for information is an opportunity for nursing to provide individualized explanation and reinforcement of the information provided during informed consent.