Informed Consent for AAA Surgery
Whether or not to undergo surgery for an abdominal aortic aneurysm (AAA), and whether to have Open or Endovascular Repair (EVAR), involves complex decision making. Patients are often not well-informed about potential adverse outcomes. In a study of post operative function, Williamson et al, (2001) found 18% of patients would not have had surgery if they understood the difficulty of the recovery process. Berman et al, (2008) conducted in-depth interviews with AAA patients who underwent AAA surgery and found some patients to perceive no choice regarding whether or not to have surgery and some patients did not feel adequately informed. Berman et al (2007) additionally found significant variation between surgeons as to which other complications for example, stroke or myocardial infarction should be discussed with patients. This demonstrates the need to develop guidelines to ensure consistent communication of appropriate risk during informed consent for AAA repair.
Our AAA QIP aims to inform improvements in informed consent for AAA repair. Please see our Patient Involvement page which includes a Patient Information Sheet for Abdominal Aortic Aneurysms. This has been developed to include up to date information on AAAs; symptoms, diagnosis, treatment options and sources of further information and advice.
When patients are fully engaged in the informed consent process, they are likely to be more satisfied with their decision and may experience better outcomes (Whitney et al 2004). The patient’s perspective is critical in order to ensure that the decision regarding AAA repair is consistent with the patient’s informed preference.
There is a need to:
- Educate patients about the nature of the diagnosis of AAA and their surgical options.
- Correct patients’ misperceptions about the nature of death from a ruptured aneurysm.
- Remove the sense of urgency from decision making.
- Communicate a baseline amount of information about the risks of intervention clearly and consistently.
- Engage family members to help with information-processing.
View article: Informed Consent for AAA repair. The Patients Perspective (pdf)
