Patients who are given brochures about their anesthesia options in advance of a procedure are more involved in the process than those provided no information, a new study shows.
“If you give patients information in the clinic about choices, they are more likely to discuss them and talk to their anesthesiologist on the day of surgery,” said Karen Posner, PhD, from the Department of Anesthesiology and Pain Medicine at the University of Washington in Seattle.
Dr Posner presented the finding here at Anesthesiology 2015.
Anesthesiologists typically don’t discuss patients’ options until the day of surgery, she told Medscape Medical News. Clinic visits usually focus on evaluating the patient and outlining how to prepare for surgery.
But now, as part of the perioperative surgical home model, professional groups are trying to engage patients in decisions to improve outcomes and reduce costs.
For their study, Dr Posner and her colleagues gave patients brochures that explain the risks and benefits of different types of anesthesia a few days or weeks before they undergo surgery with regional anesthesia.
Immediately after the clinic evaluation, the researchers surveyed these 67 patients and a control group of 59 similar patients about their knowledge of regional anesthesia and their anxiety and uncertainty. They also observed patients’ conversations during clinic visits.
Mean age of the study participants was 58 years, 54% were male, and 42% were college graduates.
Patients who received the brochures were more likely to mention and ask questions about regional anesthesia, to ask for more written information, and to score higher on a test about regional anesthesia. They were no more anxious about the procedure than those in the control group.
Table. Effects of Brochure Review
|Outcome||Brochure Group, % (n = 67)||Control Group, % (n = 59)||PValue|
|Mentioned regional anesthesia||64||49||0.015|
|Asked about regional anesthesia||70||32||0.001|
|Discussed regional anesthesia alternatives||78||52||0.016|
|Expressed a desire for more written information||71||40||0.004|
|Answered regional anesthesia questions correctly||53||30||0.001|
“They liked having this information,” said Dr Posner. “They knew more about regional anesthesia and it encouraged them to ask questions.”
This type of brochure should become standard, she said.
The language that anesthesiologists use when talking to patients makes a big difference, said session comoderator Ralf Gebhard, MD, from the division of regional anesthesia and acute perioperative pain management at the University of Miami.
“When you say there’s a possibility of nerve injury, they think they’re going to have a dead arm, not paresthesia,” he said.
Dr Posner said it is helpful to give patients a sense of the risk by providing analogies, such as comparing the level of risk with that of a plane crash or getting hit by lightning.
The brochures “have a lot of potential,” said comoderator Sophie Pestieau, MD, from the division of anesthesiology and pain medicine at the George Washington University Medical Center in Washington, DC.
“Increasing quality and safety while decreasing cost requires buy-in from the patient,” said told Medscape Medical News
The next step in this research should be to evaluate whether the brochures affected patient outcome. “Obviously, they were properly informed, but was that information useful in their decision making?” Dr Pestieau asked.
Dr Posner and Dr Pestieau have disclosed no relevant financial relationships.
Anesthesiology 2015 from the American Society of Anesthesiologists (ASA): Abstract A2211. Presented October 25, 2015.