Many patients about to undergo a heart procedure do not understand or remember the information they receive about it, according to a UK study.
The researchers say that this shows that "health literacy" is a neglected issue.
The research published yesterday (28 November 2019) found that more than 40% of patients admitted they did not understand, or remember, the details they received as part of the informed consent process for percutaneous coronary intervention (PCI).
It meant many misunderstood the benefits of the treatment. Some thought opening blocked arteries will cure them of heart disease, the report published in European Journal of Cardiovascular Nursing showed, while 31% of patients in the study needed some help to understand health-related written information.
47% said they would have liked a family member with them when their treatment was explained during the informed consent process.
Study author Professor Felicity Astin, of the University of Huddersfield, said: “Health literacy is a neglected issue. Leaflets should be in plain language. In addition, clinicians should ask patients if they need help reading or understanding health information. Patients will not volunteer that they can’t read.”
The research also found that 60% of patients with coronary heart disease undergoing elective PCI to unblock an artery thought it would cure their coronary heart disease; 95% believed it would reduce their risk of a future heart attack; while 91% thought it would increase their life span.
“These beliefs do not align with trial evidence, which shows that elective PCI is predominantly for relief of symptoms,” she said.
Professor Astin said health services should be reconfigured to allow sufficient time for patients and clinicians to discuss the proposed treatment and potential alternatives.
“Patients often receive all of the information at once. They then feel overloaded, which contributes to forgetting or not comprehending what they hear,” she added.
The authors call for patients and health professionals to work together to develop and evaluate new approaches to information sharing and decision-making.
Professor Astin said cardiologists and nurses should use “teach back” – giving small chunks of information to patients and asking them to explain it in their own words to see how much they have understood.
“The emphasis is on being a good teacher, not testing the patient and making them feel ashamed. But staff can only do this if they have the time – which is why patient pathways need to be configured,” she added.
Astin F, Stephenson J, Probyn J, et al. Cardiologists’ and patients’ views about the informed consent process and their understanding of the anticipated treatment benefits of coronary angioplasty: a survey study.Eur J Cardiovasc Nurs. 28 November 2019; doi:10.1177/1474515119879050.
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