Patient Understanding of the Importance of β-Blocker Use in the Perioperative Period

Objective: Perioperative β-adrenergic blockade has been shown to decrease morbidity and mortality after noncardiac surgery. The objective of this study was to determine patient knowledge of the importance of perioperative β-blockade in a population already taking chronic therapy and to assess the effectiveness of medical and surgical providers in patient education regarding these benefits.

Design: Survey.

Setting: Teaching hospital.

Participants: One hundred twenty-six patients taking daily β-blockers presenting to a preoperative medical evaluation clinic completed a 12-question survey that assessed their understanding of the potential benefit of taking the medication in the perioperative period.

Intervention: None.

Measurements and Main Results: Mean coronary artery disease risk factors per individual were 3.2 (standard deviation, 1.5). Forty-nine percent indicated that β-blockers are beneficial in the perioperative period. Of those identifying benefit, 8% recognized decrease in myocardial infarction or decrease in mortality as the reason. Sixty-nine percent of patients who identified perioperative benefit cited blood pressure control as the reason. This correlated to the 67% of the total sample who identified their indication for the medication as antihypertensive. Only 7% recalled their prescribing physician ever mentioning the β-blocker in relation to surgery. The same percentage recalled their surgeon mentioning it in relation to the planned procedure.

Conclusions: This study suggests low patient understanding of the potential importance and reasons for perioperative β-blockade. Patients who recognized perioperative benefit identified antihypertensive versus cardioprotective effects. Clinicians can improve education of patients already taking daily β-blockers regarding these potential benefits.

Key Words: β-blocker, patient education, perioperative, myocardial infarction