Study: Taped consultations help patients better understand CABG

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Patients who receive an audiotape of their consultation before undergoing heart surgery appear to have more knowledge about their procedures and their health, and also have reduced anxiety and depression, according to a study in this month’s Archives of Surgery.

“Patients facing heart surgery are understandably anxious in the outpatient clinic and, as a consequence, are unlikely to absorb all the information presented to them,” the authors wrote. “They also find it difficult to remember the various percentage figures quoted for risk of complication, success rate of alternative therapeutic options and other pertinent facts.”

As a result, Pankaj Kumar Mishra, MRCS, of the Glasgow Royal Infirmary in Scotland, and colleagues said this can impair the informed consent process because valid consent must be obtained from a patient who is informed about the proposed treatment, any alternatives and the nature of the underlying condition.

The researchers studied 84 patients who had first-time CABG conducted by one surgeon between February 2005 and March 2006. All of the patients’ pre-surgery consultations were audiotaped: 30 participants were randomly assigned to receive this tape and told they could listen to it whenever they desired, 25 received a general 11-minute tape about CABG and 29 received no tape. The patients were then interviewed upon being admitted to the hospital for surgery.

All patients who received the audiotaped consultations confirmed that they had listened to them; the duration ranged from 13 minutes to 32 minutes (average 24 minutes), according to the authors.

They found the average knowledge score of patients in the consultation tape group was much higher than that of individuals who received no tape. In addition, they reported a greater sense of control with regard to their own health and also scored lower on measures of anxiety and depression.

“Concerns have been raised that detailed information can cause undue anxiety and distress to patients. However, it has also been shown that a well-informed patient copes more effectively with surgery, and this factor can result in earlier discharge and decreased incidence of psychological problems,” Mishra and colleagues wrote.

“Consultation audiotaped recordings offer patients a chance to listen to information that might have been missed during the consultation and refresh their memory; the recordings facilitate understanding of illness and treatment,” they wrote. “They also encourage patients to seek clarification of previously imparted information in subsequent encounters with healthcare professionals. The addition of an audiotaped recording of an outpatient consultation to written communication significantly increases patients’ recall of information and satisfaction level, particularly in elderly patients.”

The authors concluded that additional research is needed to ensure there are no adverse effects of providing these tapes in any subgroup of patients, and also to understand how best to integrate them into clinical practice.