A new multi-center prospective randomized trial published in the American Heart Journal was able to show that a video presentation may be better at helping patients to understand the procedure and risks associated with percutaneous coronary intervention (PCI) compared to standard patient education pamphlets.
Previous studies have reported consistent results emphasizing the need for comprehensive information delivery to the patients. Moreover, interventions to improve information delivery are known to be associated with better patient satisfaction and compliance.
[perfectpullquote align=”full” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]The results showed that there was a significant increase in patient understanding of and satisfaction with information provided on coronary angiography via a dedicated educational video.[/perfectpullquote]
The trial was led by Benoit Lattuca, MD (Caremeau University Hospital, Nîmes, France) and his colleagues across France in 39 participating centers. The trial enrolled 821 patients for a 2-week period. It included patients admitted for scheduled coronary angiography, who were randomized to receive either standard information using printed hand-outs or the hand-outs plus video information by watching a 5-minute three-dimensional educational video outlining the indications for coronary angiography, the sequence of events during coronary angiography, the expected benefits of the procedure, as well as frequent and serious risks. Patients in both arms of the trial also received oral explanations regarding details of the procedure. Patients were assessed using a dedicated 16-point information questionnaire, along with evaluation based on satisfaction and anxiety scales. The results showed that there was a significant increase in patient understanding of and satisfaction with information provided on coronary angiography via a dedicated educational video. Higher level of education, previous follow-up by a cardiologist, a history of coronary angiography, prior information about coronary angiography were also associated with a higher score but the factor associated with the highest coefficient of increased understanding was the use of the video illustration.
[perfectpullquote align=”full” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]In everyday clinical practice, the best possible patient information is required to allow for an informed consent. In this study, we showed that in comparison with standard of care, the patients’ understanding of key questions regarding coronary angiography was significantly improved using an additional 5-minute educational video, in particular the consequences of pathological findings, without increasing patients’ anxiety. Information about the risks and the benefits of invasive procedures, such as coronary angiography, could benefit from a video support in addition to standard oral and written information. Dr. Latucca [/perfectpullquote]
Patients who watched the video got an average of two more questions correct than those in the standard-information group. Moreover, patients included in the video group were more than three times as likely as the standard-information group to answer the question regarding the risk of death correctly. The patients in the video group were also more likely than the standard-information group to answer correctly when asked about the procedural details of PCI, the possibility of CABG and understanding post-procedural recovery including lifelong adherence to medications. Reiterating the findings from his trial, Dr. Latucca said, “In everyday clinical practice, the best possible patient information is required to allow for an informed consent. In this study, we showed that in comparison with standard of care, the patients’ understanding of key questions regarding coronary angiography was significantly improved using an additional 5-minute educational video, in particular the consequences of pathological findings, without increasing patients’ anxiety. Information about the risks and the benefits of invasive procedures, such as coronary angiography, could benefit from a video support in addition to standard oral and written information.”
The authors addressed some limitations of the study. Firstly, the use of French language in the video limits its utilization in other regions of the world. Secondly, the study was not blinded due to the nature of intervention employed. Finally, although the educational video contained all the elements from the written informed consent form, the information provided by the physicians orally during the informed consent process may not be exactly the same as the information in the video.
While commenting on the generalization of the findings, Dr. Latucca and his team remarked, “Development of this video with 3D animations was easy and highly affordable and we showed that it improved patients’ understanding. The video can be displayed on tablet-PC, smartphone or TV screens. For example, broadcasting this video on an in-hospital tv channel would enable free dissemination of the information to patients hospitalized in the cardiology department. We therefore feel that generalization of this type of information could be integrated into standard of care.”
Source: Impact of video on the understanding and satisfaction of patients receiving informed consent before elective inpatient coronary angiography: A randomized trial, http://www.ahjonline.com/article/S0002-8703(18)30078-4/