Information Communicated with Patients in Decision Making about their Abdominal Aortic Aneurysm

Abstract 

Objectives

To explore what kind of information surgeons communicate with patients diagnosed with an abdominal aortic aneurysm, and if the information provided regarding the disorder and treatment options available complies with legal requirements.

Methods

Dutch vascular surgeons sound-recorded consultations with their patients. Recordings were scored using a checklist based on ethical considerations and five statutory categories of information on: (1) the disorder, (2) procedure and aim of surgery, (3) consequences and risks of surgery, (4) watchful observation and (5) individual prognosis regarding state of health. Each category was represented by several information items, which were scored dichotomously (‘not mentioned’ or ‘mentioned’). A category was considered sufficiently addressed if at least one of its items was mentioned.

Results

Thirty-five consultations were recorded (13 patients with aneurysmal diameter <5.5 cm and 22 with diameter ≥5.5 cm). In a minority of recordings, all five categories were addressed: 1/13 (8%) and 9/22 (41%), respectively. None of the information items was discussed consistently in every recording. Although most patients were informed about the proposed treatment option (11/13; 85% and 19/22; 86%), the alternative treatment option was mentioned only occasionally (4/13; 31% and 14/22; 64%).

Conclusions

Patients with an abdominal aneurysm are informed inconsistently about their disorder and treatment options. Information is often less than that legally required. This may hinder shared decision making.

Keywords: Abdominal aortic aneurysm, Communication, Informed consent, Legal liability, Physician–patient relations