CLINICAL ETHICS

Are patient information leaflets contributing to informed consent for cataract surgery?

H Brown¹, M Ramchandani¹, J T Gillow² and M D Tsaloumas³

¹ The Birmingham and Midland Eye Centre, Birmingham, UK
² North Staffordshire Hospital, Stoke on Trent, UK
³ Selly Oak Hospital, Birmingham, UK

Correspondence to:
Correspondence to:
Miss H Brown
The Birmingham and Midland Eye Centre, City Hospital NHS Trust, Western Road, Birmingham, UK; Hbrown{at}noncom.force9.co.uk

Aim: To assess, against a checklist of specific areas of required information and using standard published criteria, to what extent leaflets given before cataract surgery provided patients with enough information to give adequately informed consent.

Method: Twelve ophthalmology departments in the West Midlands region were asked to submit the cataract information leaflets given to their patients at the preoperative assessment for analysis. Using criteria published by the General Medical Council, British Medical Association, and Medical Defence Union the leaflets were assessed for their contribution to informed consent for patients considering cataract surgery. Leaflets were scored according to the information they provided on: diagnosis, prognosis, treatment options, costs to the patient, details about the procedure, its purpose, likely benefits, how to prepare for it, what to expect during and after the operation, and the common as well as serious complications that may occur. The readability of the information was also assessed.

Results: All the units’ leaflets provided information on diagnosis, the lifestyle changes required postoperatively, and cost involved to the patient. Only five units had leaflets that mentioned the risks involved in cataract surgery. The other areas of information were covered by 50–75% of the leaflets. Fifty per cent of the leaflets included a diagram. The average SMOG readability score was high.

Conclusion: Although present cataract information leaflets make some contribution to the process of informed consent, most do not address important areas outlined by the General Medical Council. Many of the areas of information that are required for informed consent could easily be covered, and should be borne in mind when designing patient information leaflets. Resources are available on the internet including toolkits, guides, and means of assessment for the production of patient information leaflets.

Keywords: informed consent; cataract; readability; information; leaflet

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