National Practice Patterns of Obtaining Informed Consent for Stroke Thrombolysis

Scott J. Mendelson; D. Mark Courtney; Elisa J. Gordon; Leena F. Thomas; Jane L. Holl; Shyam Prabhakaran

doi:10.1161/strokeaha.117.020474

journal article Mar 01, 2018

National Practice Patterns of Obtaining Informed Consent for Stroke Thrombolysis

Scott J. Mendelson D. Mark Courtney Elisa J. Gordon Leena F. Thomas Jane L. Holl Shyam Prabhakaran

Stroke Vol. 49 No. 3 pp. 765-767 · Ovid Technologies (Wolters Kluwer Health)

View at Publisher Save 10.1161/strokeaha.117.020474

Abstract

Background and Purpose—
No standard approach to obtaining informed consent for stroke thrombolysis with tPA (tissue-type plasminogen activator) currently exists. We aimed to assess current nationwide practice patterns of obtaining informed consent for tPA.

Methods—
An online survey was developed and distributed by e-mail to clinicians involved in acute stroke care. Multivariable logistic regression analyses were performed to determine independent factors contributing to always obtaining informed consent for tPA.

Results—
Among 268 respondents, 36.7% reported always obtaining informed consent and 51.8% reported the informed consent process caused treatment delays. Being an emergency medicine physician (odds ratio, 5.8; 95% confidence interval, 2.9–11.5) and practicing at a nonacademic medical center (odds ratio, 2.1; 95% confidence interval, 1.0–4.3) were independently associated with always requiring informed consent. The most commonly cited cause of delay was waiting for a patient’s family to reach consensus about treatment.

Conclusions—
Most clinicians always or often require informed consent for stroke thrombolysis. Future research should focus on standardizing content and delivery of tPA information to reduce delays.

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Details

Published: Mar 01, 2018
Vol/Issue: 49(3)
Pages: 765-767

Authors

S

Scott J. Mendelson

From the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).

D

D. Mark Courtney

From the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).

E

Elisa J. Gordon

From the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).

L

Leena F. Thomas

From the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).

J

Jane L. Holl

From the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).

S

Shyam Prabhakaran

From the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).

Cite This Article

Scott J. Mendelson, D. Mark Courtney, Elisa J. Gordon, et al. (2018). National Practice Patterns of Obtaining Informed Consent for Stroke Thrombolysis. Stroke, 49(3), 765-767. https://doi.org/10.1161/strokeaha.117.020474

National Practice Patterns of Obtaining Informed Consent for Stroke Thrombolysis

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