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Interventions to Improve Patient Comprehension in Informed Consent for Medical and Surgical Procedures: An Updated
Johanna Glaser1, Sarah Nouri2, Alicia Fernandez3,4
1School of Medicine, University of California, San Francisco, CA, USA.
Summary
Improving patient comprehension in informed consent is crucial. Interactive methods, especially those with teach-back, significantly enhance understanding compared to standard practices.
Area of Science:
- Medical Ethics
- Health Communication
- Patient Education
Background:
- Patient comprehension is essential for valid informed consent, yet current practices often fall short.
- Inadequate understanding can compromise the ethical and legal validity of informed consent processes.
- Existing methods require enhancement to ensure patients fully grasp medical information.
Purpose of the Study:
- To systematically review interventions aimed at improving patient comprehension during clinical informed consent.
- To evaluate the effectiveness and characteristics of various methods used to enhance patient understanding.
- To identify which interventions yield the best outcomes in informed consent processes.
Main Methods:
- Conducted systematic searches of MEDLINE and EMBASE databases from 2008 to 2018.
- Included randomized and nonrandomized controlled trials assessing interventions for informed consent comprehension.
- Utilized independent data abstraction and consensus to resolve disagreements.
Main Results:
- Sixty interventions across 52 studies were analyzed.
- Interactive digital interventions (85%) and verbal discussion with teach-back (100%) showed the highest improvement rates.
- Multicomponent (67%), audiovisual (56%), and written (43%) interventions also demonstrated significant benefits.
- Studies primarily assessed understanding of risks, general knowledge, and benefits, with less focus on alternatives or health literacy.
Conclusions:
- Interventions to improve patient comprehension in informed consent are diverse.
- Interactive approaches, particularly those incorporating test/feedback or teach-back, are most effective.
- Future research should address all informed consent elements and investigate impacts on vulnerable populations.
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