Abstract WP95: The Effectiveness of Remote Informed Consent for Clinical Intervention in the Setting of Acute Ischemic Stroke

Abstract

Background: Informed consent is an essential part of current medical practice which protects the patient’s right to make an informed decision with sufficient understanding of the risks and the benefits of any medical intervention. Because of the need to provide care quickly, consent is often obtained remotely in acute ischemic stroke. Currently, to our knowledge, no study has provided a direct measurement of effectiveness of remote consent compared to in-person consent. In this study, we surveyed those providing consent for thrombolysis and thrombectomy for satisfaction with the consent process. We also compared in person and remote consent for effectiveness in understanding of the intervention. Methods: We conducted post-consent surveys of the person consenting to either thrombolysis or thrombectomy (patient or their legally authorized representative). Surveys assessed satisfaction with the consent process including if the explanation of the procedure was clear and if they had comfortable level of understanding. Survey also included self- and objective assessments of the information provided. Patients who received thrombolysis via wake-up protocol, or as part of another research study, were excluded. Results: A total of 86 surveys assessing 61 remote and 25 in-person consents were analyzed. The in person consents were 56% thrombectomy, while remote consents were 97% thrombectomy. Both in-person and remote groups had high satisfaction rate (9.72/10 vs 9.44/10, P = 0.301) and high self-assessment of understanding (2.56/3 vs 2.74/3, P = 0.11). Objective assessment testing consenter’s knowledge of the procedure showed slightly lower performance for in-person consent, although this was statistically not significant (91% vs 93%, P= 0.17). Further analysis excluding self-consents showed no difference in the two groups (92% vs 94%, P = 0.77). Conclusion: Our observational study showed that patient and legal authorized representatives had a similarly satisfactory experience and understanding when consenting to thrombolysis/thrombectomy when consented in person compared to remote consent.