Patients with stable coronary disease who are undergoing percutaneous coronary intervention are frequently misinformed about the risks and benefits of the procedure by their physician, according to a study published in JAMA Internal Medicine.
Researchers conducted a cross-sectional study to analyze recorded conversations between Aug. 1, 2008, and Aug. 31, 2012, among adults with known or suspected stable coronary disease and their physicians at outpatient cardiology practices. The researchers were listening to the recordings to measure how often the physicians discussed all seven elements of informed decision-making pertinent to undergoing angiography and possible PCI.
Listed below are five things to know about the study findings.
1. Out of 59 conversations conducted by 23 cardiologists, only two included all seven elements of informed decision-making.
2. Eight cardiologists, or roughly 14 percent, met a more limited definition of procedure, alternatives and risks.
3. Patients who were better informed of the possible risks and benefits were less likely to choose to undergo angiography and possible PCI.
4. Specific elements significantly associated with a patient not choosing angiography and possible PCI included discussion of uncertainty, patient's role, exploration of alternatives and exploration of patient preferences.
5. Neither the presence of angina nor severity of symptoms was associated with choosing angiography and possible PCI.
"When you are facing a decision that has a number of consequences one way or the other, there are a number of issues that you are supposed to address and we found, overall, that very few conversations had all the elements," Michael Rothberg, MD, of the Center for Value-Based Care Research at Cleveland Clinic, told Reuters Health.
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