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Interactivity, Multimedia Improve Informed Consent


Authors cite improved patient understanding and reduced patient anxiety

An interactive computer program (IMP) provides better patient understanding than standard consent (SC) for radical prostatectomy (RP), according to a study published on the BJU International website.

Surgeons have legal and ethical obligations regarding the informed consent process for surgical procedures. Patients considering radical prostatectomy need to fully understand the procedure, alternatives, potential oncological outcomes, and complications, including erectile dysfunction and incontinence. Patients should also have the opportunity to revisit the risks and benefits after their initial urological consultation. The authors say that the standard consent process, which is often a verbal description of the procedure and its complications by the physician, fails to ensure that patients have understood the information. Although there are considerable multimedia resources available to physicians, the authors found little data regarding their effect on informed consent. Thus with the current study, the authors sought to compare an interactive multimedia presentation with SC.

Forty men undergoing RP randomly received SC or IMP, which was followed by a 26-item test regarding the procedure and its implications. After taking the test, the groups were crossed and re-tested. SC involved verbal interaction and discussion with physicians and nurses. IMP provided animated information on these topics, and included multiple-choice questions about key points. Patients could not progress until they responded correctly, and were required to review the information following incorrect responses before repeating the question.

Patients who used the IMP answered a mean of 78 percent of test questions correctly as compared to the SC group, which answered a mean of 57 percent of the questions correctly. After the groups switched, the IMP group maintained their scores and the SC group improved their scores by an average of 11 percent. In addition, 67 percent of participants rated the IMP as easy to use or very easy to use. Although the data are limited, the authors note that patients appeared satisfied with the IMP approach, and the IMP “thus appears likely to enhance the surgeon-patient relationship.” In addition, the IMP can record individual patients’ responses, which “might help the surgeon to identify any core misunderstandings that require more in-depth explanation,” they write.

Source: Gyomber D, Lawrentschuk N, Wong P, et al. 2010. Improving informed consent for patients undergoing radical prostatectomy using multimedia techniques: a prospective randomized crossover study. Published on March 19, 2010 on the BJU International website.