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Randomized Controlled Trial
. 2020 Feb;71(2):497-504.
doi: 10.1016/j.jvs.2019.04.460. Epub 2019 Jul 26.

Patient information sources when facing repair of abdominal aortic aneurysm

Peter B Anderson  1 , Zachary J Wanken  2 , Jennifer L Perri  2 , Jesse A Columbo  2 , Ravinder Kang  2 , Emily L Spangler  3 , Karina Newhall  2 , Benjamin S Brooke  4 , Hasan Dosluoglu  5 , Eugene S Lee  6 , Joseph D Raffetto  7 , Peter K Henke  8 , Gale L Tang  9 , Leila Mureebe  10 , Panagiotis Kougias  11 , Jason Johanning  12 , Shipra Arya  13 , Salvatore T Scali  14 , David H Stone  2 , Bjoern D Suckow  2 , Kristine Orion  15 , Vivienne Halpern  16 , Jessica O'Connell  17 , Daniel Inhat  18 , Peter Nelson  19 , Edith Tzeng  20 , Wei Zhou  21 , Michael Barry  22 , Brenda Sirovich  2 , Philip P Goodney  23 ; PROVE-AAA Study Team
Affiliations
Randomized Controlled Trial

Patient information sources when facing repair of abdominal aortic aneurysm

Peter B Anderson et al. J Vasc Surg. 2020 Feb.

Abstract

Objective: Shared medical decision making is most important when there are competing options for repair such as in treatment of abdominal aortic aneurysm (AAA). We sought to understand the sources of patients' pre-existing knowledge about AAA to better inform treating physicians about patients' needs for preoperative counseling.

Methods: We performed a multicenter survey of patients facing AAA repair at 20 Veterans Affairs hospitals across the United States as part of the Preferences for Open Versus Endovascular Repair of AAA study. A validated survey instrument was administered to examine the sources of information available and commonly used by patients to learn about their repair options. The survey was administered by study personnel before the patient had any interaction with the vascular surgeon because survey data were collected before the vascular clinic visit.

Results: Preliminary analysis of data from 99 patients showed that our cohort was primarily male (99%) and elderly (mean age 73 years). Patients commonly had a history of hypertension (86%), prior myocardial infarction (32%), diabetes (32%), and were overweight (58%). Patients arrived at their surgeon's office appointment with limited information. A majority of patients (52%) reported that they had not talked to their primary care physician at all about their options for AAA repair, and one-half (50%) reported that their view of the different surgical options had not been influenced by anyone. Slightly less than one-half of patients reported that they did not receive any information about open surgical aneurysm repair and endovascular aortic aneurysm repair (41% and 37%, respectively). Few patients indicated using the internet as their main source of information about open surgical aneurysm repair and endovascular aortic aneurysm repair (10% and 11%, respectively).

Conclusions: Patients are commonly referred for AAA repair having little to no information regarding AAA pathology or repair options. Fewer than one in five patients searched the internet or had accessed other sources of information on their own. Most vascular surgeons should assume that patients will present to their first vascular surgery appointment with minimal understanding of the treatment options available to them.

Keywords: Abdominal aortic aneurysm; Decision aid; EVAR; Information; Patient education; Shared decision making.

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Figures

Figure 1:
Figure 1:
Study design for our study of preferences for abdominal aortic aneurysm repair type.
Figure 2:
Figure 2:
Survey results assessing main source of information about EVAR.
Figure 3:
Figure 3:
Survey results assessing main source of information about OAR.
Figure 4:
Figure 4:
Survey results assessing whether patient has spoken to PCP about treatment options.
Figure 5:
Figure 5:
Survey results assessing how patient’s views of treatment options have been influenced.
See this image and copyright information in PMC

References

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