Original title: Variation in patients’ perceptions of elective percutaneous coronary intervention in stable coronary artery disease: cross sectional study. Referencia: Kureshi F et al. BMJ. 2014;Epub ahead of print.
This study included 991 consecutive patients with stable coronary disease undergoing elective PCI in 10 university and community centers between 2009 and 2011. After procedure, patients were asked a series of questions about their perception of the urgency and benefits of PCI. 44% had had a previous intervention and 85% were symptomatic with angina or dyspnea.
90% of the population reported PCI would prolong their lives, 88% reported it would prevent eventual infarctions and 20% reported it was an emergency procedure, despite the fact that all of them were elective. Only 1% of patients reported that the only benefit expected from this procedure was the relief of symptoms.
Some interesting characteristics of patients influenced their perception of PCI. The youngest most frequently believed that PCI could save their lives, in addition to the prevention of infarction and symptoms relief. Married patients, as opposed to single ones, also exaggerated the benefits of PCI and those less educated were more frequently inclined to think PCI was an emergency procedure. However, not only did these characteristics influence patients’ opinions, but also operators’ opinions. Patients undergoing PCI handled by more experienced elder cardiologists were more often convinced that PCI would prolong their lives. Another issue that influenced outcomes was whether consent was obtained by the operator himself, by a fellow or by a nurse.
Conclusion
Most of patients undergoing elective PCI have little information about the risks and benefits of this procedure.
Editorial Comment
The moment patients sign the informed consent form is their last opportunity to make questions and inform themselves about the risks and benefits of this procedure, and this is why professionals in charge (operator, fellow or nurse) must be able to answer any question that may arise. Explicitly writing objective figures about possible complications or benefits is no simple task and may turn out to be rather uncomfortable for many patients and doctors.
SOLACI