Percutaneous endoscopic gastrostomy: adequacy and quality of information given to decision makers

Nowadays percutaneous endoscopic gastrostomy (PEG) is widely available, but patient-selection criteria and quality of informed consent are debated. The aims of this retrospective study were to evaluate the quality of information given to the decision-makers (relatives) and determine the overall acceptance of the procedure by the patients' family.

The relatives of patients with PEG were interviewed by telephone, using a structured questionnaire. They (n = 55; 36% spouses, 34% children, 30% other) gave information about themselves and the patient (34 males, 21 females, median age 69, range 16-92 years) who underwent PEG tube placement for eating disorders or dysphagia.

At the time of evaluation 30/55 (54.6%) patients had died. The cumulative median survival was significantly longer in patients younger than 75 years by 58 days (p = 0.009). Relatives believed that PEG could improve the patients' quality of life (56%) or/and the underlying disease. Although 93% of the decision-makers considered that their opinion had been taken into account when the procedure was done, 25% said that they had not adequately been informed about alternative methods and the complications of the procedure (38%). 54% said that the procedure had improved the quality of life of the family. Most of the decision-makers believed that their decision was correct (87%) and they would recommend PEG (84%) to other patients suffering from dysphagia.

Though several decision-makers were not satisfied with the quality of information given before informed consent, the overall acceptance of the PEG placement for nutritional support is high.