Abstract TP77: Patient Understanding Of And Satisfaction With Acute Stroke Treatments

Abstract

Background: We aimed to assess patient and family understanding of and satisfaction with communication regarding acute stroke treatments of intravenous thrombolysis (IVT) and endovascular therapy (EVT). Methods: The study was conducted at a health system in the United States from November 2020 to May 2021. A structured interview with open-ended and multiple choice questions was conducted over telephone or in person within 72 hours of therapy to patients or surrogates with whom acute stroke treatments were discussed. The respondent satisfaction and self-reported understanding were rated on a Likert scale. Responses to open ended questions on recall of diagnosis, purpose, risks, and benefits of treatments were evaluated by two blinded raters. Results: Of 128 patients who met inclusion criteria, 15 refused, 54 were unavailable and 56 completed interviews. Twenty four participants were patients and 32 were surrogates. Forty-two participants were white and 39 had education of high school graduation or above. Thirty five received IVT alone, 11 IVT and EVT, 12 EVT alone. Forty participants were extremely satisfied with the care patients received in the stroke care unit. Forty-six (71%) reported to have no difficulty in understanding the purpose of treatments, and 36 (64%) reported no difficulty understanding risks. Upon specific evaluation, 83% (38/46) had a good recall of the purpose but only 17% (8/46) named 2 or more risks for IVT. For EVT, 87% (20/23) had a good recall of purpose and 9% (2/23) named 2 or more risks. “Bleeding in the brain” was the most reported risk for IVT (n=22) and “lack of benefit” for EVT (n=11). Conclusions: Most patients and surrogates are extremely satisfied with acute stroke treatment. Despite the majority reporting no difficulty in understanding the risks of acute stroke treatments, only a small minority were able to recall and verbalize two or more risks.