DALLAS – April 03, 2023 – Multiple studies have demonstrated that Black patients are significantly less likely than white patients to undergo invasive cardiovascular procedures. Prior research also has demonstrated substantial racial disparities in the use of implantable cardioverter-defibrillators (ICDs) that can be lifesaving for those at high risk for sudden cardiac death.
Agreeing to have an ICD, though, relies on patients having a clear understanding of the potential benefits of the procedure as well as trust in their care team. Cardiologists at Duke University, including Eric Peterson, M.D., M.P.H., who served at Duke before joining UT Southwestern Medical Center in 2020, investigated whether an educational video that used both white and Black physicians and patients might increase patients’ willingness to consider an ICD.
“Racial health disparities are often complex and multifactorial. Yet empowering patients to better understand their disease and potential treatment options is one way to help overcome this,” said Dr. Peterson, Vice Provost and Senior Associate Dean for Clinical Research at UTSW and the study’s lead author.
The findings, published in Annals of Internal Medicine, examined two separate facets. First, it looked to see whether the video would affect patients’ decision-making process. The study found that rates of ICD implantation were not different among those randomized to the video versus not, about 60% in each. However, the researchers did find that patients seeing the video felt they understood their options better and had to spend less time with their physicians to reach a decision.
Second, the researchers examined whether the video’s impact was altered by whether the race of the characters in the video matched that of the patient. Interestingly, racial concordance or discordance had no impact on the video’s effectiveness.
The researchers concluded that better educational tools could engage more patients and give them confidence in their treatment decisions. However, education alone will not fully rectify complex differences in procedural use by race. Since a high percentage of Black patients in both arms were willing to undergo the procedure, Dr. Peterson concluded that the major underlying causes for ICD disparities may lie more with who is offered the costly device rather than on who agrees to the procedure.
Dr. Peterson holds the Adelyn and Edmund M. Hoffman Distinguished Chair in Medical Science.
The study was supported by a Patient-Centered Outcomes Research Institute Program Award (AD-1503-29746).
About UT Southwestern Medical Center
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 24 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,900 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits a year.
