Ingle M Pilar, Lammons William, Guigli Rebecca, Kini Vinay, Matlock Daniel D, Brereton Elinor, Scherer Laura D
Graduate School of Social Work, University of Denver, Denver, CO, USA.
Section of Neonatal Medicine, Division of Public Health and Primary Care, Faculty of Medicine, Imperial College London, London, UK.
Patient Prefer Adherence. 2021 Apr 12;15:721-728. doi: 10.2147/PPA.S302146. eCollection 2021.
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.
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.
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.
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.
越来越多的证据表明，冠状动脉支架对稳定型冠状动脉疾病（CAD）患者的益处并不确定。本研究的目的是评估患者的信息需求，以及患者对有关冠状动脉支架对CAD患者益处不确定的信息的反应。
对近期接受支架治疗的稳定型CAD患者进行了半结构化定性访谈（N = 20）。使用混合归纳-演绎方法对数据进行编码和分析。
一些患者错误地认为他们植入支架的目的是预防未来的心脏病发作，而且很少有人之前意识到益处的不确定性。几乎所有患者都认为他们的手术取得了积极的结果，即使他们的症状仍然存在。一些患者难以接受支架可能不会降低心脏病发作风险或可靠改善症状的证据。尽管如此，患者仍然表示希望获得有关支架益处不确定的新信息，并希望在治疗早期就得到这些信息。
许多稳定型CAD患者不了解冠状动脉支架的预期益处，并且希望被告知冠状动脉支架益处不确定的证据，即使这不会改变他们的决定。需要改进沟通和患者教育工具，以便更好地告知患者。早期为患者提供这些信息的干预措施有可能解决这些问题。
