[Informed consent as viewed by patients participating in cardiology drug trial].

BACKGROUND In clinical tests, the Informed Consent is critical to preserve the ethics, but due to its high complexity level, it cannot be fully understood. This study assesses the Informed Consent as viewed by patients. OBJECTIVE We addressed the issue of what do patients understand about the studies based on the IC. METHODS We invited participants of outpatient clinical drug trials phase II, III and IV to answer a questionnaire with 29 questions, such as: why have you accepted to participate? Did you read the Informed Consent before signing it? By signing it, were you sure you have fully understood it? Eighty individuals (20 women and 60 men) showed up, from 106 patients. The variables of each question were considered as often as they appeared. The comparison of the averages among the groups was made by t tests of Student or Wilcoxon; and for associations, Chi-square or Likelihood Ratio, or Fisher's exact test. RESULTS Ages averaged 58.7 +/- 9.3 years. Concerning their reasons to taking part in the survey, 66.2% pointed out their own benefit; 42.5%, for science's sake; 25.0% claimed they were doing so at their doctor's request; 50% did not understand the Informed Consent properly; and 32.9% did not read it, but signed it. Among those who were administered placebo after randomization (n = 47), 66.7% did not understand the meaning of the informed consent. A strong correlation between failure to understand the meaning of placebo with literacy level (p = 0,02) was verified, which is an evidence that the smaller is the literacy level, the smaller is the understanding level. CONCLUSION The Informed Consent is poorly understood by patients and for some of them, trusting a doctor affected their decision in taking part in the clinical trial with drugs. Their literacy level also influenced their understanding of the term 'placebo'.

[1]  Amélia Artes Indicador nacional de alfabetismo funcional-2001: explorando as diferenças entre mulheres e homens , 2007 .

[2]  Elaine Alves,et al.  Conflito de interesses em pesquisa clínica , 2007 .

[3]  E. Verástegui Consenting of the vulnerable: the informed consent procedure in advanced cancer patients in Mexico , 2006, BMC medical ethics.

[4]  L. Myer,et al.  Informed consent and participant perceptions of influenza vaccine trials in South Africa , 2005, Journal of Medical Ethics.

[5]  Nelson Massanobu Sakaguti O conhecimento de usuários de serviços públicos de saúde envolvidos em pesquisas clínicas, sobre seus direitos , 2005 .

[6]  James Flory,et al.  Interventions to improve research participants' understanding in informed consent for research: a systematic review. , 2004, JAMA.

[7]  J. Osuch The power of the doctor, the vulnerability of the patient, and informed consent. , 2004, Surgical neurology.

[8]  Colin Sharp Qualitative Research and Evaluation Methods (3rd ed.) , 2003 .

[9]  Fábio Montenegro,et al.  Indicador nacional de alfabetismo funcional, 5º: um diagnótico para inclusão social pela educação: avaliação da leitura e escrita , 2003 .

[10]  Mary T Roth,et al.  Health Literacy: A Review , 2002, Pharmacotherapy.

[11]  R. Horton,et al.  The clinical trial: deceitful, disputable, unbelievable, unhelpful, and shameful--what next? , 2001, Controlled clinical trials.

[12]  S. Díaz,et al.  Informed consent procedures: responsibilities of researchers in developing countries. , 2001, Bioethics.

[13]  D. Fitzmaurice,et al.  A systematic review of patient information leaflets for hypertension , 2000, Journal of Human Hypertension.

[14]  M. Coovert,et al.  Strategic physician communication and oncology clinical trials. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[15]  R. Lilford,et al.  Informed consent for clinical trials: in search of the "best" method. , 1998, Social science & medicine.

[16]  R. Holcombe,et al.  Informed consent for clinical trials: a comparative study of standard versus simplified forms. , 1998, Journal of the National Cancer Institute.

[17]  D C McCrory,et al.  Getting Meaningful Informed Consent from Older Adults: A Structured Literature Review of Empirical Research , 1998, Journal of the American Geriatrics Society.

[18]  M. Angell The ethics of clinical research in the Third World. , 1997, The New England journal of medicine.

[19]  Nina S. Parikh,et al.  Inadequate functional health literacy among patients at two public hospitals. , 1995, JAMA.

[20]  J. Kitzinger,et al.  Qualitative Research: Introducing focus groups , 1995 .

[21]  E. Baráth,et al.  Fundamentals of Biostatistics. , 1992 .

[22]  P. Tubino,et al.  Conflito de interesses em pesquisa clínica Conflict of interests in clinical research , 2007 .

[23]  A. Jatene CONSELHO NACIONAL DE SAÚDE RESOLUÇÃO No 196 DE 10 DE OUTUBRO DE 1996 , 2006 .

[24]  Roque Moraes,et al.  Analise de conteudo , 1999 .

[25]  Márcia Faria Westphal,et al.  Grupos focais: experiencias precursoras em programas educativos em saude no Brasil , 1996 .

[26]  M. Patton Qualitative research and evaluation methods , 1980 .