Patient Preference and Adherence (Apr 2021)
Patient Perspectives on the Benefits and Risks of Percutaneous Coronary Interventions: A Qualitative Study
Abstract
M Pilar Ingle,1 William Lammons,2 Rebecca Guigli,3 Vinay Kini,4 Daniel D Matlock,5 Elinor Brereton,6 Laura D Scherer4 1Graduate School of Social Work, University of Denver, Denver, CO, USA; 2Section of Neonatal Medicine, Division of Public Health and Primary Care, Faculty of Medicine, Imperial College London, London, UK; 3Data Science to Patient Value, University of Colorado School of Medicine, Aurora, CO, USA; 4Division of Cardiology, University of Colorado School of Medicine, Denver, CO, USA; 5Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA; 6Adult & Child Consortium for Outcomes Research & Delivery Science, University of Colorado School of Medicine, Aurora, CO, USACorrespondence: Laura D SchererDivision of Cardiology, University of Colorado School of Medicine, 13199 E. Montview Blvd. Suite 300, Aurora, CO, 80045, USATel +1 303-772-8872Email [email protected]: Growing evidence for coronary stents in patients with stable coronary artery disease (CAD) suggests that the benefits of stents are uncertain. The goal of this study was to assess patients’ informational needs and how patients react to information about the uncertain benefit of stents to CAD patients.Methods: Semi-structured qualitative interviews (N=20) were conducted with patients with stable CAD who received a recent stent. Data were coded and analyzed using a mixed inductive-deductive approach.Results: Some patients mistakenly believed that the purpose of their stent was to prevent a future heart attack, and few were previously aware of the uncertain benefit. Nearly all patients perceived positive outcomes from their procedure, even if their symptoms persisted. Some patients had difficulty accepting evidence that stents may not reduce the risk of heart attack or reliably improve symptoms. Nonetheless, patients still expressed a desire to receive new information about the uncertain benefits of stents and wanted to have received this information early in their care.Conclusion: Many patients with stable CAD do not understand the intended benefit of coronary stents and want to be informed of the evidence of uncertain benefit of coronary stents, even if this would not change their decision. Improved communication and patient education tools are needed to better inform patients. An intervention providing patients with this information early has the potential to solve these problems.Keywords: qualitative research, patient communication, patient education, coronary stents, coronary artery disease
