Simpler language improved patients’ recall of mesh-related risks


AT SGS 2014

The patients’ mean age was 53 years; 83% were white and 66% had some college education or more, reported Dr. McFadden. On average, they had almost 15 years of education.

The percentage of physicians who mentioned various immediate risks of mesh ranged from 94% for bleeding to 97% for organ damage (mean, 95%). Patient recall scores at 6 weeks after surgery ranged from 71% for bleeding to 90% for the need for a catheter (mean, 80%).

The percentage of physicians who mentioned the long-term risks of mesh ranged from 30% for continued leakage and groin pain to 92% for mesh erosion, a notable high outlier (mean, 58%). Patient recall scores ranged from 33% for chronic urinary tract infection to 95% for continued leakage (mean, 68%).

Surgeons were significantly more likely to mention the immediate risks than the long-term risks (95% vs. 58%; P less than .01), but patients were similarly likely to recall these two groups of risks.

When referring to the midurethral sling implant, surgeons most commonly used the terms mesh (87%) and tape (81%), and less commonly used the term graft (14%). On average, there were 5.9 uses of mesh per consent session, 7.4 uses of tape, and 0.5 uses of graft.

A variety of sociodemographic factors (patient age, education, race/ethnicity, and health literacy score) and consent-related factors (duration of the discussion, mesh term used, and number of uses) were not significantly associated with patients’ recall of risks.

But the lower the grade level at which the surgeon spoke, the greater patients’ recall was (r = –0.26, P less than .05).

Dr. McFadden disclosed no relevant conflicts of interest.


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