How Do Patients Perceive the Benefits and Risks of Peripheral Angioplasty? Implications for Informed Consent
Received 7 September 2007; received in revised form 20 October 2007; accepted 22 October 2007.
Purpose
To explore perceptions of benefits and risks of patients undergoing peripheral angioplasty and to investigate factors that modify them.
Materials and Methods
Two hundred patients undergoing peripheral angioplasty during a 12-month period (134 men and 66 women; mean age, 68.8 years; age range, 37–94 years) were interviewed by one interventional radiologist who asked 18 questions with regard to the risks and benefits of this procedure. The patients were randomly assigned into two groups of 100 patients. The first group answered questions with use of a recognized risk assessment chart. The other group answered without the aid. Depending on the referral pathway, patients received the institution’s patient information sheet.
Results
Of the 200 patients, 178 (89%) thought that they would have at least a 75% (three in four) chance of benefiting from angioplasty. Eighty patients (40%) thought they would definitely benefit from angioplasty. One hundred one patients (50%) thought the test would be painful. Fifty-four patients (27%) thought there would be no radiation exposure. Forty-one patients (21%) realized there was a chance of needing emergency surgery. Sixty-seven patients (34%) thought the test was easier than anticipated. Previous peripheral angioplasty altered perceptions of benefit (P = .012), but not risk. The use of a risk assessment chart altered perceptions of benefit (P = .049). The use of a patient information sheet predicted (made more realistic) the patients’ perceptions of risks (P = .012) and benefits (P = .001).
Conclusions
Patients who undergo peripheral angiography tend to underestimate the risks and overestimate the benefits of peripheral angioplasty. The patient information sheet and risk assessment tool used in this study altered patient perceptions of risks and benefits of the procedure and, therefore, aid informed consent.
aNottingham University Hospitals—Queen’s Medical Centre Campus, Radiology Department, Nottingham, NG7 2UH, UK
bDepartment of Radiology, Addenbrooke’s Hospital Cambridge, UK
cInstitute of Nuclear Medicine, UCL University College Hospital, 235 Euston Rd, London, NW1 2BU, UK.
Address correspondence to A.M.G.
None of the authors have identified a conflict of interest.
1 S.B.H., T.C.S., and A.M.G. are members of the Addenbrooke’s Radiology 1998 Intake Group.
ABSTRACT