Bugajski M, Wieszczy P, Pisera M, Rupinski M, Hoff G, Huppertz-Hauss G, Regula J, Bretthauer M, Kaminski M F
Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland.
Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Center for Postgraduate Education, Warsaw, Poland.
Endosc Int Open. 2019 Apr;7(4):E537-E544. doi: 10.1055/a-0830-4648. Epub 2019 Apr 3.
European guidelines (ESGE) recommend measuring patient experience and 30-day complication rate after colonoscopy. We compared digital and paper-based feedback on patients' experience and 30-day complications after screening colonoscopy. Screenees attending for primary screening colonoscopies in two centers from September 2015 to December 2016 were randomized (1:1) to an intervention arm (choice of feedback method) or control arm (routine paper-based feedback). Participants in the intervention arm could choose preferred feedback method (paper-based, automated telephone or online survey) and were contacted by automated telephone 30 days after colonoscopy to assess complications. Control group participants self-reported complications. Primary and secondary endpoints were response rates to feedback and complications questionnaire, respectively. There were 1,281 and 1,260 participants in the intervention and control arms, respectively. There was no significant difference in response rate between study groups (64.8 % vs 61.5 %; = 0.08). Free choice of feedback improved response for participants identified as poor responders: younger than 60 years (60.8 % vs 54.7 %; = 0.031), male (64.0 % vs 58.6 %; = 0.045) and in small non-public center (56.2 % vs 42.5 %; = 0.043). In the intervention arm, 1,168 participants (91.2 %) answered the phone call concerning complications. A total of 79 participants (6.2 %) reported complications, of which two (0.2 %) were verified by telephone as clinically relevant. No complications were self-reported in the control group. The overall response rate was not significantly improved with digital feedback, yet the technology yielded significant improvement in participants defined as poor responders. Our study demonstrated feasibility and efficacy of digital patient feedback about complications after colonoscopy.
欧洲指南(ESGE)建议对结肠镜检查后的患者体验和30天并发症发生率进行测量。我们比较了关于筛查结肠镜检查后患者体验和30天并发症的数字反馈和纸质反馈。2015年9月至2016年12月在两个中心接受初次筛查结肠镜检查的受检者被随机(1:1)分为干预组(反馈方法选择)或对照组(常规纸质反馈)。干预组的参与者可以选择首选的反馈方法(纸质、自动电话或在线调查),并在结肠镜检查后30天通过自动电话联系以评估并发症。对照组参与者自行报告并发症。主要和次要终点分别是对反馈和并发症问卷的回复率。干预组和对照组分别有1281名和1260名参与者。研究组之间的回复率没有显著差异(64.8%对61.5%;P = 0.08)。对于被确定为低回复者的参与者,自由选择反馈方式提高了回复率:年龄小于60岁者(60.8%对54.7%;P = 0.031)、男性(64.0%对58.6%;P = 0.045)以及在小型非公立中心的参与者(56.2%对42.5%;P = 0.043)。在干预组中,1168名参与者(91.2%)接听了关于并发症的电话。共有79名参与者(6.2%)报告了并发症,其中两名(0.2%)经电话核实为临床相关并发症。对照组中没有自行报告并发症的情况。数字反馈并未显著提高总体回复率,但该技术在被定义为低回复者的参与者中产生了显著改善。我们的研究证明了结肠镜检查后关于并发症的数字患者反馈的可行性和有效性。