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Patient and Physician Perspectives on Cardiovascular Risk: A Multicenter Study of Communication Gaps

Gorriz-Magana, J.; Maruri-Sanchez, R.; Elorriaga, A.; Salterain-Gonzalez, N.; Prieto-Lobato, A.; Gascuena Rubia, R.; Monedero Sanchez, I.; Laffond, A. E.; Lapena Reguero, M.; Leandro Barros, A.; Villabona Rivas, C.; Gutierrez Fernandez, A.; Jimenez Mendez, C.; Prieto-Gonzalez, S.; Melendo-Viu, M.; Alcon Duran, B.; Blanco-Lopez, E.; Bonanad, C.; Durante-Lopez, A.; Carrasquer, A.; Martinez-Losas, P.; Alvarado Casas, T.; Pajaro Merino, P.; Juarez-Olmos, V.; Lopez Pais, J.; Kittleson, M.; Diez-Villanueva, P.; Baneras, J.

2024-12-03 health systems and quality improvement
10.1101/2024.12.02.24318359 medRxiv
Show abstract

BackgroundEffective risk communication is crucial for managing cardiovascular disease, the leading cause of global mortality. Clear communication between patients and physicians is essential for informed decision-making, yet gaps in understanding often persist. ObjectiveThis study examines the state of risk communication during hospital admissions for cardiovascular events, evaluating both patient and physician perspectives and identifying factors influencing risk perception. MethodsThe SEC-HARIPA study is a multicenter, cross-sectional analysis conducted across 28 Spanish centers from October 2022 to March 2023. It included 943 patients admitted to cardiology departments, either urgently or for scheduled procedures. Patients and their physicians completed parallel questionnaires assessing perceptions of cardiovascular risk, procedural complications, and overall communication. Statistical analysis focused on agreement between patient and physician perceptions and the impact of demographic and clinical variables. ResultsThe mean age of participants was 68.2 years, with ischemic heart disease being the most common cause of admission (41.3%). While 76.9% of patients felt adequately informed about procedural risks, 69.3% of those experiencing adverse events reported a lack of information on potential complications. A significant discrepancy was found between patients and physicians perceptions of future cardiovascular risk, with patients often underestimating their risk (weighted kappa index of 0.29). Key factors influencing risk perception included prior cardiovascular history, age, gender, and diabetes mellitus. ConclusionsThis study reveals significant gaps in risk communication in cardiovascular care, particularly regarding future risks and complications. Tailoring communication strategies to individual patient characteristics could improve understanding and align perceptions with clinical realities, enhancing health outcomes.

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