Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2)
Background: Obtaining consent in emergency situations is challenging. Proxy consent allows patients to be recruited when they lack capacity, a common scenario in stroke patients. The rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 (RIGHT-2) recruits patients in the pre-hos...
| Main Authors: | , , , , , , |
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| Format: | Conference or Workshop Item |
| Published: |
2018
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| Online Access: | https://eprints.nottingham.ac.uk/50649/ |
| _version_ | 1848798305627144192 |
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| author | Scutt, Polly Dixon, Mark Appleton, Jason P. Howard, Harriet Havard, Diane Woodhouse, Lisa J. Bath, Philip M. |
| author_facet | Scutt, Polly Dixon, Mark Appleton, Jason P. Howard, Harriet Havard, Diane Woodhouse, Lisa J. Bath, Philip M. |
| author_sort | Scutt, Polly |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: Obtaining consent in emergency situations is challenging. Proxy consent allows patients to be recruited when they lack capacity, a common scenario in stroke patients. The rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 (RIGHT-2) recruits patients in the pre-hospital setting within 4 hours of stroke onset.
Methods: In RIGHT-2, informed or proxy consent is taken in the ambulance. A brief assessment of capacity is performed by the paramedic. Patients with capacity provide consent and in patients without capacity, proxy consent is obtained from a relative, carer or friend, or by the paramedic, witnessed by a crew member.
Results: Of 879 participants enrolled into RIGHT-2 as of 15th December 2017, 468 (53.2%) participants gave their own consent; proxy consent was given by a relative/carer/friend for 325 (37%) and by a paramedic for 85 (9.7%). Participants who consented themselves were younger, had less dependency and had less severe strokes than those with proxy consent. Participants who gave their own consent had a lower rate of intracerebral haemorrhage (9% vs 16%) and a higher rate of non-stroke (20% vs 13%) as their final diagnosis than those who gave proxy consent. Consenting patients had better scores for dependency, cognition, disability and quality of life at day 90 than those recruited via proxy consent.
Conclusion: Proxy consent can ensure participants are enrolled rapidly into emergency clinical trials where they may otherwise be excluded due to lack of capacity. These patients have more severe strokes and therefore poorer clinical outcomes. |
| first_indexed | 2025-11-14T20:17:40Z |
| format | Conference or Workshop Item |
| id | nottingham-50649 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:17:40Z |
| publishDate | 2018 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-506492020-05-04T19:33:22Z https://eprints.nottingham.ac.uk/50649/ Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) Scutt, Polly Dixon, Mark Appleton, Jason P. Howard, Harriet Havard, Diane Woodhouse, Lisa J. Bath, Philip M. Background: Obtaining consent in emergency situations is challenging. Proxy consent allows patients to be recruited when they lack capacity, a common scenario in stroke patients. The rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 (RIGHT-2) recruits patients in the pre-hospital setting within 4 hours of stroke onset. Methods: In RIGHT-2, informed or proxy consent is taken in the ambulance. A brief assessment of capacity is performed by the paramedic. Patients with capacity provide consent and in patients without capacity, proxy consent is obtained from a relative, carer or friend, or by the paramedic, witnessed by a crew member. Results: Of 879 participants enrolled into RIGHT-2 as of 15th December 2017, 468 (53.2%) participants gave their own consent; proxy consent was given by a relative/carer/friend for 325 (37%) and by a paramedic for 85 (9.7%). Participants who consented themselves were younger, had less dependency and had less severe strokes than those with proxy consent. Participants who gave their own consent had a lower rate of intracerebral haemorrhage (9% vs 16%) and a higher rate of non-stroke (20% vs 13%) as their final diagnosis than those who gave proxy consent. Consenting patients had better scores for dependency, cognition, disability and quality of life at day 90 than those recruited via proxy consent. Conclusion: Proxy consent can ensure participants are enrolled rapidly into emergency clinical trials where they may otherwise be excluded due to lack of capacity. These patients have more severe strokes and therefore poorer clinical outcomes. 2018-02-22 Conference or Workshop Item PeerReviewed Scutt, Polly, Dixon, Mark, Appleton, Jason P., Howard, Harriet, Havard, Diane, Woodhouse, Lisa J. and Bath, Philip M. (2018) Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2). In: 4th European Stroke Organisation Conference (ESOC 2018), 16-18 May 2018, Gothenburg, Sweden. (In Press) |
| spellingShingle | Scutt, Polly Dixon, Mark Appleton, Jason P. Howard, Harriet Havard, Diane Woodhouse, Lisa J. Bath, Philip M. Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) |
| title | Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) |
| title_full | Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) |
| title_fullStr | Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) |
| title_full_unstemmed | Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) |
| title_short | Consent procedures and relationship with outcome in the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) |
| title_sort | consent procedures and relationship with outcome in the rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 (right-2) |
| url | https://eprints.nottingham.ac.uk/50649/ |